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In Summary OA is a widespread and devastating condition that leads to pain, diminished normal activities, and high healthcare costs. Because increasing emphasis is being placed on cost-efficient treatment (including increasing use of bundled payments), further work is needed to understand the costs and cost-savings of accurate diagnosis and treatments before surgery and the efficacy of novel treatment options. As we are learning more everyday about the pathogenesis of OA, and that it is not just “wear and tear,” it is opening the door to new treatment avenues. Given the multiple pathways involved in the disorder, a multidisciplinary approach to treatment and prevention is likely the future treatment of OA