Osteoarthritis year in review 2025: Biomechanics

Biomechanical loading is a known contributor to osteoarthritis (OA) pathogenesis, and one of the few modifiable risk factors. Thus, research on biomechanics offers an opportunity to gain valuable insights into disease mechanisms, patient impact, and potential intervention targets. This narrative review synthesizes literature on biomechanics in human OA populations published between April 2024 and March 2025. Of the 180 included articles, many focused on in-laboratory walking biomechanics in individuals with knee OA or used biomechanical measures to evaluate surgical or rehabilitation interventions. In addition, three emerging themes were identified that reflect evolving directions in the field: (1) innovation through open science, novel tools, and analytic methods; (2) expansion beyond traditional gait assessments; and (3) more holistic, multidimensional evaluation of the OA patient. Studies suggest growing interest in a range of low-cost, open-access tools and techniques-from wearable sensors to musculoskeletal modeling to machine learning approaches-as well as greater integration of biomechanical, biological, psychosocial, and patient-reported data. While traditional gait analysis remains central, recent work highlights the value of capturing movement across diverse tasks, examining multi-joint effects, and considering both patient-specific and environmental context. Together, these advances support a promising shift toward more accessible, contextually relevant, and clinically meaningful OA biomechanics research, and point to important opportunities for continued innovation, standardization, and collaboration. Future work integrating scalable, real-world biomechanics may help clarify whether these measures could ultimately be incorporated into routine clinical care or serve as clinical trial endpoints.