Learn What is Osteoarthritis and Osteoarthritis Treatment

1. Osteoarthritis http://stemcellorthopedicinstituteoftexas.com/osteoarthritis/

2. What is Osteoarthritis? • Osteoarthritis is the most common type of osteoarthritis characterized by degeneration of the articular cartilage and ultimately joint destruction.  It is estimated that 27 million Americans 25 years of age and older have clinical osteoarthritis of some joint, with a higher percentage of affliction in the older population. • Human aging is associated with bone and joint degenerative changes that include loss of bone density and ligament flexibility. Chronic musculoskeletal pain accounts for the most medical complaints in the United States with nearly 15 million Americans reporting dysfunction in activities of daily living (ADL’s) as a result of a musculoskeletal ailment.

3. What is Osteoarthritis? • Osteoarthritis is a progressively debilitating and irreversible disease that affects mostly cartilage and associated changes in the bone and synovium.  Once considered only in the elderly, osteoarthritis is seen in younger patients, affecting all joints such as the hands, knees, hips and the spine being the major problematic sites. • Generally, cartilage defects in Osteoarthritis are usually large, unconfined and affect more than one location • Acute cartilage injury often occurs in normal young patients and probably requires localized treatment in contrast to patients with Osteoarthritis in the elderly where the entire joint surface will require treatment. This cartilage damage eventually leads to decreased function and loss of mobility and autonomy for the patient

4. What is Osteoarthritis? • Osteoarthritis is a complex condition with broad pathology with clear links to other conditions such as neuropathic pain, depression, and sleep disorder, and is often characterized as a biomechanical disease associated with abnormal joint loading from obesity, joint instability, or trauma, and inflammation of the joints, and genetics. • There is a poor understanding in the disease mechanism of Osteoarthritis associated with: • A lack of biomarkers of early disease. • Slow progression. • Signaling pathways, biomechanical events and cellular functions remain obscure.

5. What is Osteoarthritis? Manifestations of Osteoarthritis include: • Joint pain. • Impairment to movement. • Local tissue inflammation surrounding the joint. Much of the Osteoarthritis research today has focused on the loss of articular cartilage by: • Insufficient repair response • Mechanical stresses. • Aging or dead cells that cannot produce cartilage.

6. Synovial Changes • The synovium plays a crucial role in the development of Osteoarthritis of the joint.  Synovial inflammation occurs in the majority of patients and is a predictive factor in the disease progression. • Infiltration of T cells and macrophages are increased in the synovium in early Osteoarthritis. This indicates synovial inflammation is a feature in early disease and might be an indicator of future tissue destruction. • The synovium seems to have two faces to its role in Osteoarthritis • Inflammatory • It may be the focus of effective repair responses involving local populations of mesenchymal stem cells (called MSC’s), where the MSC’s become activated and are capable of differentiating into cartilage, bone and other tissue which might provide repair cells to help to maintain healthy joints.

7. Current Treatment in Osteoarthritis • It is a striking fact that no appropriate pharmacological intervention, biological therapy or procedure prevents the progressive destruction of the osteoarthritic joint.  All current treatment regimens produce symptomatic rather than regenerative results, for example: • Non-steroidals for pain. • Viscosupplementation with injection of sodium hyaluron (Synvisc) • Nutraceuticals like chondroitin sulfate, omega 3- fatty acids, etc

8. Current Treatment in Osteoarthritis • Non-pharmacological and pharmacologic treatments are used for early and moderately early cases of Osteoarthritis, but protection of the articular cartilage has not been shown. • None of these treatments have a useful impact on the progressive loss of joint tissues that leads to the total joint replacement. • Total joint replacement can be successful resulting in enhanced mobility and reduction in pain, but surgical procedures come with associated risks, which include: • Thrombosis, infection and a very high cost in hospitalization and rehabilitation. • There is also an increased risks of Osteoarthritis after meniscus or ACL injury.

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