Advances in sensor integration for real-time monitoring of joint-on-chips

Joint-on-chip (JoC) platforms represent a transformative approach to modeling the complex functional units of joints, offering valuable tools for disease modeling, drug discovery, and biomarker identification. However, the field faces two key challenges: the accurate recapitulation of the multifaceted joint environment and the lack of integrated online readouts to monitor cellular and tissue responses in real-time. This review underscores the importance of capturing the interplay of joint tissues and highlights the potential of diverse monitoring strategies—including optical, electrical, mechanical, and biochemical modalities—for real-time assessment. Drawing on examples from musculoskeletal and other organ-on-chip systems, we discuss current advancements and gaps in the field. Finally, we provide a forward-looking perspective on how addressing these limitations can accelerate the development of robust JoC platforms for translational musculoskeletal research.