7/17/2019 Learn What is Osteoarthritis and Osteoarthritis Treatment

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Osteoarthritishttp://stemcellorthopedicinstituteoftexas.com/osteoarthritis

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7/17/2019 Learn What is Osteoarthritis and Osteoarthritis Treatment

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 What is Osteoarthritis?

• Osteoarthritis is the most common type of osteoarthritischaracterized by degeneration of the articular cartilage and

ultimately joint destruction. It is estimated that 27 million mericans 2! years of age and older ha"e clinicalosteoarthritis of some joint# $ith a higher percentage ofa%iction in the older population.

• &uman aging is associated $ith bone and jointdegenerati"e changes that include loss of bone density and

ligament 'exibility. (hronic musculos)eletal pain accountsfor the most medical complaints in the *nited +tates $ithnearly ,! million mericans reporting dysfunctionin acti"ities of daily li"ing -0s1 as a result of amusculos)eletal ailment.

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 What is Osteoarthritis?

• Osteoarthritis is a progressi"ely debilitating and irre"ersibledisease that aects mostly cartilage and associated changes in the

bone and syno"ium. Once considered only in the elderly#osteoarthritis is seen in younger patients# aecting all joints suchas the hands# )nees# hips and the spine being the majorproblematic sites.

• 3enerally# cartilage defects in Osteoarthritis are usually large#uncon4ned and aect more than one location

•  cute cartilage injury often occurs in normal young patients and

probably re5uires localized treatment in contrast to patients $ithOsteoarthritis in the elderly $here the entire joint surface $illre5uire treatment. 6his cartilage damage e"entually leads todecreased function and loss of mobility and autonomy for thepatient

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 What is Osteoarthritis?

• Osteoarthritis is a complex condition $ith broad pathology$ith clear lin)s to other conditions such as neuropathic

pain# depression# and sleep disorder# and is oftencharacterized as a biomechanical disease associated $ithabnormal joint loading from obesity# joint instability# ortrauma# and in'ammation of the joints# and genetics.

• 6here is a poor understanding in the disease mechanism ofOsteoarthritis associated $ith:

•  lac) of biomar)ers of early disease.

• +lo$ progression.

• +ignaling path$ays# biomechanical e"ents and cellular functionsremain obscure.

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 What is Osteoarthritis?

anifestations of Osteoarthritis include:

•  8oint pain.

• Impairment to mo"ement.

• ocal tissue in'ammation surrounding the joint.

uch of the Osteoarthritis research today hasfocused on the loss of articular cartilage by:

•

Insuicient repair response• echanical stresses.

•  ging or dead cells that cannot producecartilage.

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Synovial Changes

• 6he syno"ium plays a crucial role in the de"elopment ofOsteoarthritis of the joint. +yno"ial in'ammation occurs in the

majority of patients and is a predicti"e factor in the diseaseprogression.

• In4ltration of 6 cells and macrophages are increased in thesyno"ium in early Osteoarthritis. 6his indicates syno"ialin'ammation is a feature in early disease and might be anindicator of future tissue destruction.

• 6he syno"ium seems to ha"e t$o faces to its role in Osteoarthritis

• In'ammatory• It may be the focus of eecti"e repair responses in"ol"ing local populations

of mesenchymal stem cells -called +(0s1# $here the +(0s becomeacti"ated and are capable of dierentiating into cartilage# bone and othertissue $hich might pro"ide repair cells to help to maintain healthy joints.

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Current Treatment in Osteoarthritis

• It is a stri)ing fact that no appropriatepharmacological inter"ention# biological therapy

or procedure pre"ents the progressi"e destructionof the osteoarthritic joint. ll current treatmentregimens produce symptomatic rather thanregenerati"e results# for example:

• 9onsteroidals for pain.

•  ;iscosupplementation $ith injection of sodium hyaluron-+yn"isc1

• 9utraceuticals li)e chondroitin sulfate# omega < fattyacids# etc

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Current Treatment in Osteoarthritis

• 9onpharmacological and pharmacologic treatments areused for early and moderately early cases of Osteoarthritis#

but protection of the articular cartilage has not been sho$n.• 9one of these treatments ha"e a useful impact on the

progressi"e loss of joint tissues that leads to the total jointreplacement.

• 6otal joint replacement can be successful resulting inenhanced mobility and reduction in pain# but surgical

procedures come $ith associated ris)s# $hich include:• 6hrombosis# infection and a "ery high cost in hospitalization and

rehabilitation.

• 6here is also an increased ris)s of Osteoarthritis after meniscus or ( injury.

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