Feb
27
2013

Joint Replacement For Osteoarthritis Of The Knee Will Become Obsolete

Osteoarthritis of the knee joints is one of the most common forms of arthritis of the aging person. Often the patient starts feeling pain when walking for a long time or when climbing stairs, more so when walking down. Eventually there is swelling of the knees, pain and inflammation (the affected knee feels hot). When the condition deteriorates over a period of 5 to 10 years, the patient notices a decrease in range of motion in the joint and it may affect the gait as the patient favors one knee. The physician or physical therapist may suggest the use of a cane. Later the patient may need a walker to get around.

In the following I will describe two possible ways of treating this condition in the end stage followed by unconventional ways of treating osteoarthritis to hopefully prevent disabilities.

The conventional treatment of osteoarthritis (total knee replacement)

The typical way of treating knee osteoarthritis in an early case is to order physical therapy treatments and to give anti-inflammatory medication to treat the swelling and pain. Anti-inflammatory medicine with NSAIDs is not harmless as it can lead to severe gastric bleeding from gastric erosions. On the longer term it can cause kidney damage with kidney failure, possibly requiring dialysis. In a moderate case an orthopedic surgeon may inject hyaluronic acid and steroids, which may give relief for up to 6 or 9 months. Eventually the pain and the restriction with regard to the range of motion become so severe that the orthopedic surgeon recommends a total knee replacement. This can be quite successful with respect to relieving most of the pain, but often it is less than 100% satisfactory with regard of regaining range of motion.

Osteoarthritis Of Knee With Degenerative Joint Changes

Osteoarthritis Of Knee With Narrowed Cartilage

The new way of treating osteoarthritis (mesenchymal stem cell transplant):

In a case publication from Korea an alternative new treatment for osteoarthritis has been published with two typical cases described, both Korean women, one aged 70, the other  one aged 79. Both were assessed by orthopedic surgeons and found to be severe enough to qualify for total knee replacements. However,  both declined, as they were afraid of the risks associated with surgery. Instead both patients received mesenchymal stem cells transplants derived from their abdominal fat by liposuction.  The transplant was done by injections into their knees using a small needle on several occasions weeks apart. This is known as a transplant with autologous adipose-tissue-derived stem cells. Within only 12 weeks from the date of the stem cell treatment the patients noticed a 90% improvement of the pain, and similar progress with regard to increase in range of motion was noted. MRI scans were done just before the stem cell treatment and again 12 weeks after the treatment. Here is the MRI image of the 79 year-old woman’s knee before and 12 weeks after her procedure.

According to the authors of this publication these cases were new reports on human subjects compared to previously successful reports with animal experiments. They felt that more human trials would be required, to show on a larger scale that end stage osteoarthritis can be treated successfully with tissue stem cells taken from the patient’s own abdominal fat.

Alternative treatment for osteoarthritis

In Europe there was a lot of interest in the 1980’s in the use of glycosaminoglycan polysulfate (which was sold as “Arteparon”). It was derived from hyaline cartilage of calf knee joints.

It was available as an injectable medicine and produced by the Luitpold Pharmaceutical company. Only a two or three injections into an affected joint would be needed to cure about 70% to 80% of patients with osteoarthritis. Later it was shown that simple intramuscular injection rather than specific joint injection had the identical cuarative effect for osteoarthritis. One injection was only about 3$ to 5$. However, in 1991 the Munich company in Germany was sold to a Japanese pharmaceutical firm and Arteparon was no longer produced, so it was only known in Europe, as it never made it to the US market. Since then Synvisc came onto the market in the US in the early 2000’s. Now one injection was 150$ (!). However, a randomized study showed that Synvisc is only about 15 to 20% more effective than placebo after three to five injections (450$ to 750$).

However, the word was out that there are non-toxic substances that are part of the natural cartilage which would be useful in treating osteoarthritis. Glucosamine and chondroitin are often combined in supplements for osteoarthritis and you can get this in the health food store. The American Family Physician reported about non-conventional supplements for osteoarthritis in its January 2008 edition.

Perhaps equally important to this is to approach osteoarthritis from the nutritional angle, namely in terms of cutting out refined sugar and starches. It has been observed that osteoarthritis develops mostly in the industrialized countries where sugar consumption is the highest. Not so on the islands of Okinawa. Recently a study showed that sugar from soft drink consumption contributes to worsening osteoarthritis, especially in men. It follows from this that your food intake should be modified to provide optimal nutrients for healthy joint maintenance. Read this article, which describes in detail what you should eat to reverse osteoarthritis.

Omega-3 fatty acids are also useful, but higher doses are required for arthritis reversal than are required for healthy heart maintenance.  About 2.7 Grams of Omega-3 fatty acids per day are required, such as two to three capsules of high quality molecularly distilled fish oil capsules three times per day. This will help  balance the overload from omega-6 fatty acids in processed foods.

Another approach to help with joint pains from osteoarthritis is through chicken cartilage. It appears that with the initial degenerative changes of joint cartilage with osteoarthritis, collagen is exposed to the immune system, which responds with the production of T killer cells, which attack the joint cartilage. Research has shown that a tolerance state of the immune system is created when you take chicken cartilage (either fikzol type II or UC-II) for only 90 days. The body tolerates the chicken cartilage supplement and the joint surfaces recover from the prior degenerative changes.

Finally, studies regarding DMSO and MSM(methylsulfonylmethane) are not very conclusive, except perhaps for one study on knee osteoarthritis as this link shows.

By nutritional intervention (cutting out refined sugar and refined carbohydrates) and following what was summarized under point 3 above, many people with minor osteoarthritis may not progress further to the end stage where either procedure 1 or 2 above would have to be done.

This is an example of how medicine is moving forward. The technique has been developed for osteoarthritis and also for osteonecrosis of the hip joint as described in the same publication. In the past laparoscopic procedures have replaced older, more invasive surgical procedures with better results and less complications. In a similar vein these newer stem cell transfer procedures can replace, at least partially the more invasive total joint replacements with less dangers to the patient. Should a mesenchymal stem cell transplant not be successful, the patient can still return to a conventional total knee or total hip joint replacement.

More information on osteoarthritis: http://nethealthbook.com/arthritis/osteoarthritis/

Here is a limited selection regarding  regenerative or restorative centers in the US (I have no financial interest or other bias with respect to any of these treatment centers):

http://www.regenexx.com/about-regenexx/doctor-christopher-j-centeno-md/

http://www.the-stem-cell-center.com/

http://www.stemcellrevolution.com/

http://tulane.edu/som/regenmed/

Last updated Nov. 6, 2014

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