Osteoarthritis (OA) is the most common chronic musculoskeletal disorder. It can affect any joint and is the most frequent single cause of disability in older adults.

OA is a progressive degenerative disease involving the entire joint structure in a vicious circle that includes the capsule-bursa tissue inflammation, synovial fluid modifications, cartilage breakdown and erosions, osteochondral inflammatory damage leading to bone erosion and distortion.

Research has identified the initial inflammatory-immunologic process that starts this vicious cycle leading to so-called early OA. Research has also identified the role played in the disease advancement by synoviocytes type A and B, chondrocytes, extracellular matrix, local immune-inflammatory mediators and proteases.

This article investigates the joint-resident MSCs that play an essential local homeostatic role and regulate cell turn over and tissue repair. Resident MSCs establish and maintain a local regenerative microenvironment.

The understanding of OA physiopathology clarifies the core mechanisms by which minimally invasive interventions might be able to halt and reverse the course of early stage OA. Interventions employing PRP, MSCs and exosomes are considered in this article.

骨关节炎（OA）是最常见的慢性肌肉骨骼疾病。它可以影响任何关节，是老年人中最常见的残疾原因。

OA是一种进行性退行性疾病，涉及整个恶性循环的整个关节结构，其中包括囊囊囊炎，滑液变质，软骨破裂和糜烂，软骨软骨炎性损害，导致骨质侵蚀和变形。

研究已经确定了开始这种恶性循环的最初的炎症-免疫过程，从而导致了所谓的早期OA。研究还确定了滑膜细胞A和B，软骨细胞，细胞外基质，局部免疫炎症介质和蛋白酶在疾病进展中的作用。

本文研究了联合驻地MSC，它们起着重要的局部稳态作用，并调节细胞翻转和组织修复。居民MSC建立和维持当地的再生微环境。

对OA生理病理学的理解阐明了微创干预可能阻止和逆转早期OA病程的核心机制。本文考虑采用PRP，MSC和外泌体的干预措施。