For the more than 30 million sufferers of osteoarthritis in the U.S., excruciating, unrelenting pain is a part of their everyday life. When this condition affects the knee joint, it can prevent a person from movement. This lack of motion can lead to other chronic conditions – such as heart and lung disease – which can result from obesity caused by the person being in more sedentary state.
According to the National Institute of Health, osteoarthritis is a degenerative disease that “is caused by a breakdown of cartilage- the tissue that covers the ends of bones where they form a joint. Healthy cartilage allows bones to glide over one another, and it absorbs energy from the shock of physical movement. In osteoarthritis, the surface layer of cartilage breaks down and wears away. This results in bones under the cartilage rubbing together causing pain, swelling, and stiffness. Bone spurs develop, permanently changing the joint’s shape.”
A Joint Specialist Looks at Osteoarthritis of the Knee
Dr. Donald Hohman is a board certified, fellowship trained orthopedic surgeon who specializes in total joint replacement and adult reconstructive procedures of the hip and knee. He also participates in the referral line of Texas Health Spine & Orthopedic Center and has treated osteoarthritis of the knee in hundreds of patients.
“Patients who experience symptoms from osteoarthritis of the knee commonly complain of a feeling of stiffness when they first start to use the knee and this stiffness is often associated with pain. It is common, however, for a patients stiffness to improve as they continue to use the knee more.
“Unfortunately, the pain is typically worsened with activity. Often there is swelling associated with use of the knee. As the process progresses the symptoms become more regular and function of the knee continues to decline.”
Current Treatments of Osteoarthritis
“Osteoarthritis of the knee can be treated with several modalities that have demonstrated successful return to function and relief of symptoms,” Dr. Hohman said. “These treatments include dedicated physical therapy for strengthening the muscles surrounding the knee and relieving pressure on the deteriorating joints. There are also several types of injections which have been shown to provide relief of symptoms including corticosteroid injections as well as visco-supplementation.
“Additionally, depending on the type of deformity the knee has and where the arthritis is within the knee joint, bracing can oftentimes be very effective. When medications are considered, over-the-counter pain medications, including Tylenol, can be very effective for the management of arthritis pain.
“When all of these non-surgical options have been attempted and patients are no longer experiencing relief of their symptoms, joint replacement surgery can be a consideration. Joint replacement operations can include minimally invasive options for deteriorating joints depending on the location of the wear within the knee. Partial knee replacements can be very effective and these can be considered for isolated wear within individual compartments of the knee. If the entire knee joint is involved, then a total knee replacement can be a very successful operation for pain relief.
Is Regeneration from Stem Cell Therapy a Viable Treatment?
Encouraging the body to regenerate tissue such as knee cartilage by using the person’s own stem cells is a very exciting prospect for osteoarthritis sufferers. Unfortunately, more research is necessary before this is a reality. Dr. Hohman explains.
“Generally speaking, stem cells are uncommitted cells,” he said. “The theoretical potential of these cells is that they may hold the ability to become any type of cell including skin, organ tissues, or even the cartilage cells which are deteriorating and damaged in arthritic knees. Stem cells can come from different locations including fetal tissue and they can also come from a patient’s own adult stem cells that can be harvested from bone marrow and fat.”
“Most everyone would agree that the potential for the use of these cells within medicine is very exciting. Based on statistics from the Arthritis Foundation there are over 30 million Americans with osteoarthritis. Those numbers make it easy to see why there is a strong interest in this technology.
“Researchers have suggested using stem cells for the treatment of cartilage damage in arthritic knees. The hope is that the injection of stem cells into the joints would potentially help to regenerate cartilage in the osteoarthritic joints. However, the ability to regenerate tissue in a laboratory setting does not immediately translate into medical practice. Unfortunately, the enthusiasm for this treatment option has outpaced the science behind it and current technologies do not appear to be providing any significant benefits for patients undergoing these treatments.”
Physicians who are members of the referral line practice independently and are not employees or agents of Texas Health Spine & Orthopedic Center.