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Various studies have suggested that macrophages might respond to stimuli in their microenvironment by changing their phenotypes to pro\u2010inflammatory or anti\u2010inflammatory phenotypes, which is called macrophage polarization. Macrophages accumulate and become polarized (M1 or M2) in many tissues, such as synovium, adipose tissue, bone marrow, and bone mesenchymal tissues in joints, while resident macrophages as well as other stromal cells, including fibroblasts, chondrocytes, and osteoblasts, form the joint and function as an integrated unit. In this study, we focus exclusively on synovial macrophages, adipose tissue macrophages, and osteoclasts, to investigate their roles in the development of OA. We review recent key findings related to macrophage polarization and OA, including pathogenesis, molecular pathways, and therapeutics. We summarize several signaling pathways in macrophage reprogramming related to OA, including NF\u2010\u03baB, MAPK, TGF\u2010\u03b2, JAK\/STAT, PI3K\/Akt\/mTOR, and NLRP3. Of note, despite the increasing availability of treatments for osteoarthritis, like intra\u2010articular injections, surgery, and cellular therapy, the demand for more effective clinical therapies has remained steady. Therefore, we also describe the current prospective therapeutic methods that deem macrophage polarization to be a therapeutic target, including physical stimulus, chemical compounds, and biological molecules, to enhance cartilage repair and alleviate the progression of OA.<\/jats:p>","DOI":"10.1111\/os.13993","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T22:15:16Z","timestamp":1706739316000},"page":"532-550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Emerging Roles of Macrophage Polarization in Osteoarthritis: Mechanisms and Therapeutic Strategies"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9559-480X","authenticated-orcid":false,"given":"Zimu","family":"Yuan","sequence":"first","affiliation":[{"name":"West China Medical School Sichuan University  Chengdu China"},{"name":"West China Hospital Sichuan University  Chengdu 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