What is the Prognosis for Osteoarthritis?

Are all osteoarthritis patients destined to get worse?

Osteoarthritis prognosis. Getty Images Credit: Jan-Otto

Do All Osteoarthritis Patients Get Worse?

Newly diagnosed arthritis patients want to know their prognosis almost as soon as they hear their diagnosis. They want to know what will happen and what to expect years down the road. Osteoarthritis, especially, is saddled with a certain amount of negativity: it's an old person's disease, and it just gets worse. How accurate is that, though?

Osteoarthritis is viewed by most people as a gradual wearing out of the joints — you could say it's slowly progressive.

The most current research, though, indicates that not all osteoarthritis patients worsen; some actually stabilize.

Rapidly progressive joint damage is not common in osteoarthritis. While about 40% of older people have x-ray evidence revealing significant osteoarthritis in their hips and knees, less than 5% will have joint replacement surgery. Based on that fact alone, osteoarthritis does not continue to worsen for most patients.

What Happens as Osteoarthritis Develops?

Medical experts portray an accurate osteoarthritis prognosis this way:

  • Most osteoarthritis cases do stabilize.
  • Some osteoarthritis cases progress.
  • A small number of osteoarthritis patients improve spontaneously.

Osteoarthritis has active and less active phases. During the active phases, osteophytes form, the joint capsule thickens, subchondral bone (the layer of bone under cartilage) changes and there is cartilage loss. Even with x-ray evidence of osteoarthritis during the different phases, a patient can still be free of osteoarthritis symptoms.

Comorbidities Contribute to Disability

The prognosis of osteoarthritis is not necessarily bad. Remember, too, that older people commonly have comorbidities (conditions that occur together). For a person with osteoarthritis, comorbidities may be more responsible for worsening disability than osteoarthritis itself.


Primer on the Rheumatic Diseases. Thirteenth Edition. Osteoarthritis: Course, Prognosis, and Outcome. Paul Dieppe MD. p.227.

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