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<p class="abstract">Osteoarthritis (OA) is the most common joint disease affecting millions worldwide. Osteoarthritis typically affects the knees, hands, hips, and feet. It is characterized by complex pathologic changes in cartilage which haven’t been fully elucidated yet. However, recent research has shown the involvement of two contributing pathways namely the mechanical and the immune pathways which interlink to cause cartilage destruction. Patients with OA on current treatment options still inevitably progress to a more severe stage becoming candidates for total joint replacement. The cornerstones of OA management in the early stage include exercises, weight loss, education—complemented by topical or oral nonsteroidal anti-inflammatory drugs (NSAIDs) and nutraceuticals like Undenatured type II collagen and Aflapin. Both Undenatured type II collagen and Aflapin offer great promise in OA management by targeting both the immune and mechanical pathways respectively. Undenatured type II collagen works by oral tolerization turning off the immune response in the inflammatory damage (T cell response) against endogenous Type II collagen in the cartilage thus reducing joint inflammation and degradation and stimulates anti-inflammatory cytokine release. Aflapin inhibits 5-LOX and exerts anti-inflammatory action thus providing symptomatic relief of pain and inflammation. This review focusses on the role of mechanical and immune pathways in the pathogenesis of OA and the impact of the combination of Undenatured type-II collagen and Aflapin in targeting these pathways thus improving the clinical outcomes.</p>

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