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Evans DR, Parikh VV, Khan MM, Coussons C, Buckley PF, Mahadik SP

8 Remaining Questions and Knowledge Gaps There is strong evidence that synovitis drives worse outcomes in osteoarthritis, contributing to more severe and persistent pain, heightened pain sensitization, faster structural deterioration, and an increased need for joint replacement

There are clearly observable patterns: doses that keep appearing across unrelated users, cycle lengths that cluster around specific injury types, and timing decisions that reflect real physiological consistency

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