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This review explores the therapeutic potential of engineered EVs in joint diseases, particularly in comparison to their parental stem cells. Recent research underscores the efficacy of EVs in treating joint diseases, especially Osteoarthritis (OA). We discuss EV engineering strategies aimed at overcoming the limitations of natural EVs. Data from preclinical trials, clinical studies, and in\u00a0vitro and in\u00a0vivo reports are analyzed to evaluate the effectiveness of EVs in treating joint conditions. In addition to their role in intercellular communication, EVs influence various biological processes crucial for bone remodeling, cartilage regeneration, immunomodulation, and inflammation control. EVs are rich in vital biomolecules such as proteins, microRNAs (miRNA), lipids, and nucleic acids, which enhance their therapeutic potential compared to parental stem cells. This understanding is key to developing targeted and effective engineered EVs for OA and other joint diseases. A comprehensive grasp of EV engineering and underlying mechanisms will pave the way for novel and efficient therapies for arthritic diseases and related conditions.<\/jats:p><jats:p>This article is categorized under:\n<jats:list list-type=\"simple\">\n<jats:list-item><jats:p>Implantable Materials and Surgical Technologies &gt; Nanotechnology in Tissue Repair and Replacement<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Nanotechnology Approaches to Biology &gt; Cells at the Nanoscale<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Biology\u2010Inspired Nanomaterials &gt; Peptide\u2010Based Structures<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p>","DOI":"10.1002\/wnan.70031","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T04:41:28Z","timestamp":1755664888000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Engineered Extracellular Vesicles in Arthritic 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