Postulating that osteoarthritis (OA) is not a single disease entity, Dr. Perruccio is endeavouring to identify distinct subgroups of individuals in OA. The particular interest lies in systemic effects in OA, primarily inflammation. The identification of distinct clinical subgroups may suggest different etiologies, disease trajectories, and/or responses to medical and surgical treatment, and, consequently, a need for a more refined epidemiological profiling of OA, possible changes to OA prevention, treatment and management strategies, and a need to carefully consider such subgroups when designing clinical trials. His work is summarized by three research themes: 1. Sex differences in OA; 2. Inflammation in OA and comorbidity; and 3. Spine OA and back pain.

Sex differences in OA. Surgical interventions have shown great effectiveness in reducing OA-related disability (often hip and knee replacement and spinal fusions). However, a significant (and costly) minority report ‘poor’ outcomes. Understanding and predicting who does poorly is critical to mitigating personal and societal costs and improving overall patient outcomes. We are undertaking work to identify subgroups of OA surgical patients at greater risk of poor outcomes. Findings to date suggest potentially sex- and inflammation-dependent OA subgroups which may have unique clinical response profiles. Work continues in identifying OA subgroups and understanding likely sex differences in this regard.

Inflammation in OA and the risk of comorbidity. Several clinical and population-based studies have reported that people with OA are significantly more likely to have multiple other chronic conditions (i.e. comorbidity) in comparison to age- and sex-matched peers in the general population. Most notable are diseases for which inflammatory mediators are known to have a pathophysiological role. Work is underway to determine whether OA subgroups characterized by systemic inflammation are at greater risk for comorbid disease onset. This work links clinical data with provincial health administrative data and is being performed in collaboration with researchers from the Institute of Clinical and Evaluative Sciences (ICES).

Spine OA and back pain. Spine OA (SOA) has largely been ignored in discussions of the prevalence and effect of OA. Low back pain (LBP) is among the leading reasons for seeking primary health care and disability. While it is recognized that LBP can have a wide range of etiologies and symptom profiles, the vast majority of cases presenting to primary care are considered “non-specific”, with an implied mechanical or non-specific etiology. Understanding whether individuals with likely SOA are among those presenting with LBP is important for addressing prevention and treatment. We are undertaking studies to determine whether LBP subgroups are epidemiologically distinct and whether certain subgroups have profiles more consistent with those typically reported for other OA populations.


For a list of Dr. Perruccio's publications, please visit PubMed, Scopus or ORCID.

Scientific Associate, Arthritis Program, Toronto Western Hospital
Assistant Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, and Department of Surgery, Faculty of Medicine, University of Toronto
Investigator, Arthritis Community Research and Evaluation Unit and UHN Arthritis and Autoimmunity Research Centre