Tired of taking bunches of pills for arthritis? Here’s an alternative… next
Better than a pill: Team to develop new arthritis treatment via silk
Erika Ebsworth-Goold writing in Medical Xpress reported a team of researchers from Washington University in St. Louis will use silk micro-particles to deliver long-lasting therapeutic compounds, helping better alleviate the pain of inflammation and injury.
“We’re starting to see that many areas can’t be reached via oral drug delivery,” said Lori Setton, the Lucy & Stanley Lopata Distinguished Professor of Biomedical Engineering at the School of Engineering & Applied Science.
Setton, said an intracellular compound called nuclear factor kappa B (NF-kB) is a main culprit in cellular breakdown, inflammation and pain after an injury. She’s working in the lab on a new solution using silk to deliver two specific molecules that can inhibit NF-kB at the site of a fracture or injury in an effort to stave off long-term joint damage.
“Silk naturally doesn’t interact with water, and, when you mix it with these molecules that also don’t interact with water, they bind to each other very strongly,” Setton said. “We believe these selective compounds are therapeutically effective, but we’ve never been able to get them to their target site. By delivering them with the silk, we hope to get large doses to the target site with low toxicity and to have them remain in that compartment for longer periods of time.”
Silk is an attractive delivery vehicle because of its long history of safe clinical use
According to Setton, the enhanced drug-delivery system has the potential to prevent the onset and progression of joint damage in patients suffering from acute injuries, like minor joint fractures, ligament or meniscal tears.
“Patients with joint trauma tend to go on to develop osteoarthritis at a higher rate compared to someone who doesn’t have the injury,” Setton said. “It’s a whole different type of arthritis development that we don’t know a whole lot about, but we believe we can intervene early with new drug delivery and treatments, and prevent onset at a later stage.”
Your orthopedic surgeon wants to do arthroscopic surgery for your meniscus… better watch out!
Arthroscopic surgery for degenerative meniscus tears increases risk for eventual knee replacement
A recent study published in the journal Osteoarthritis Cartilage showed that patients with osteoarthritis of the knee who undergo arthroscopic surgery for degenerative meniscus tears are at markedly increased risk for potentially having total joint replacement. In the study, 335 patients with osteoarthritis of the knee underwent arthroscopic surgery for degenerative meniscus tears. They were followed for two years.
The authors demonstrated that in patients with knee osteoarthritis, arthroscopic knee surgery with meniscectomy is associated with a 3 fold increase in the risk for future knee replacement surgery.
Comment: Don’t do it if you can avoid it. The meniscus serves of function. It helps to cushion the knee. Any meniscus tissue should be preserved.
And your surgeon says you need surgery… maybe not… next
Meniscal Tears May Not Need Surgery
Jack Cush reporting in RheumNow cited a study published in the British Medical Journal examines whether knee surgery or conservative medical management benefits those with degenerative meniscal tears. Patients with knee pain from a degenerative meniscal tear were randomized to either arthroscopic surgery (followed by daily exercises at home) or physical therapy (neuromuscular and strength exercises) two to three times a week for 12 weeks.
Over the next 2 years both groups improved. Muscle strength had improved more, on average, in the physical therapy group at the three-month checkup, but at the final two-year checkup, there was essentially no difference between the surgery and therapy groups, including in pain, ability to function in sports and recreation activities, and quality of life. The researchers noted that 19 percent of the therapy group opted to have surgery at some point but had achieved “no additional benefit” by the end of the study.
Conservative exercise therapy was equal to arthroscopic intervention overall, but also showed positive effects over surgery short-term muscle strength. Clinicians should consider conservative management and physical therapy in middle-aged patients with degenerative meniscal tears.
Comment: Degenerative meniscus tears are secondary to the arthritis. Surgery is not generally warranted.
Did you know your nose could help your knees. Find out how next…
Aching Knee? Surgeons Pioneer Groundbreaking New Operation Taking Tissue From The NOSE To Grow Cartilage That May Be Due To Osteoarthritis!
Roger Dobson writing for the Daily Mail reported surgeons are taking tissue from the nose to grow cartilage to fix knee-joint pain.
The operation sees cartilage harvested from the nose, which is then used to grow patches of tissue to be transplanted on to knee joints.
The procedure is regarded as particularly beneficial for osteoarthritis patients, or those at risk of the joint disease, and doctors carrying out the operation say it could help thousands of people.
The most widely used procedure to repair the injury involves trimming any remaining damaged tissue and drilling holes in the bone beneath the defect to trigger bleeding and scar tissue that, it is hoped, can work as a substitute tissue.
But according to the NHS, results are variable, with studies suggesting that it offers only short-term benefits and does not lead to the formation of new cartilage.
Comment: The procedure is a bit risky for only short term relief but maybe it will improve.
Hope for young people with bad osteoarthritis of the hips… next
Stem Cells Could Replace Hip Replacements
Christopher Wanjek writing for Live science reported scientists have coaxed stem cells to grow new cartilage on a scaffold shaped like the ball of a hip joint. This is a major step toward being able one day to use a patient’s own cells to repair a damaged joint, thus avoiding the need for extensive joint-replacement surgery.
In addition, the scientists used gene therapy to grant this new cartilage the ability to release anti-inflammatory molecules when needed. If done in patients, this technique could help prevent a return of arthritis, if that was what damaged the joint in the first place.
The new technique may be ready to test in humans within three to five years and may ultimately work with other joints, such as knees, said Farshid Guilak, a professor of orthopedic surgery at Washington University School of Medicine in St. Louis, who co-led the project.
Comment: We stopped doing stem cell procedures for hips at our center because we weren’t getting the results we wanted. While this approach looks like it might work I’m reserving judgement. The hip has a unique mechanical structure that makes any type of stem cell procedure problematic..