Knee pain after 50: What is knee osteoarthritis?
Knee arthritis (OA) relates to chronic pain and conditions in most adults of all ages, especially starting at age fifty years old. OA is the degenerative process of losing cartilage in the hip and presents symptoms such as increased pain when performing daily activities such as walking, climbing stairs, and standing leisurely for long periods. Patients are often told by health practitioners that a knee joint replacement is the only long-term corrective technique when OA has advanced. However, the advancement of the technology used in regenerative medicine has provided additional options to patients for conservatively managing OA prior to considering surgery.
Most advanced forms of regenerative treatment for knee OA include Platelet Rich Plasma (PRP) and other non-surgical orthopaedic approaches which are aimed at encouraging the body's own healing process. Are these regenerative treatments capable of delaying and/or decreasing surgery for knee OA? There is no right or wrong answer for this question because there are many factors (level of arthritis; patient health; & patient expectations) which will help determine how each patient responds to either of these treatments.
In an exclusive interaction with TheHealthSite.com, Dr. Sharmila Tulpule, Consultant Orthopedic and an American Board-certified Regenerative Medicine specialist; Founder & Director, Orthobiologix Biotech Pvt Ltd), explained that knee OA is defined as a disease of the knee joint involving the gradual destruction of cartilage (the tissue covering the ends of long bones). As this tissue fails to protect the joint, there are also many types of additional changes to the knee in addition to those caused by degeneration of cartilage. These changes all cause pain, swelling, lack of mobility, and inflammation.
The first step in managing symptoms related to OA is usually lifestyle changes, followed by physiotherapy, weight loss, and possibly treatment with medications for the treatment of painful symptoms or aggravating factors (e.g. inflammation), and in some patients, injections into the knee.
If the conservative approaches fail to relieve the patient's knee OA symptoms and result in limited abilities to engage in preferred physical activities, the usual option is to proceed with a total versus partial knee replacement. Not all patients will qualify for surgery; some may be too young to have surgery, want to wait until later before having surgery, or have another medical condition prohibiting or are not recommended to have surgery.
PRP therapy uses your own body's own blood to extract some rest uses rest materials (from your blood) that will be re-injected into your knees. With the help of the PRP (Platelet Rich Plasma) you created new umbilical cord blood are able restore fluid build-up in knees along with repair damaged tissues caused by arthritis. This is done with the injection of PRP directly through your knee joint.
Once injected PRP signals your immune system and triggers repair and regeneration, thereby impairing the normal inflammatory response (which actually causes pain), along with providing nutrients, removing cells in need of replacement and allowing the growth of new tissue.
Many clinical studies have been conducted on the use of PRP for the treatment of knee osteoarthritis and many of these studies have shown significant reductions in pain and improved level of functioning in patients with mild moderate knee osteoarthritis through the use of the PRP treatment. In general, PRP users have experienced a decrease in pain, increased mobility and new ability to carry out daily functions for several months after injection.
Regenerative orthopedic therapy is gaining popularity due to its desire to aid with reducing joint inflammation, repairing damaged tissues, and enhancing the quality of the knee joint's micro-environment. While these therapies are not designed to cure or reverse how osteoarthritis affects people, they may lessen the severity of people's symptoms and help to slow down how fast the disease progresses.
Many researchers have studied how biological methods of treating osteoarthritis work with traditional physiotherapy, medications, and lifestyle modification so that people will have the opportunity to experience less pain, improve their range of motion, and enhance their overall well-being when using these treatments in conjunction with complete rehabilitation programs.
The answer for many patients who have been diagnosed with early to moderate knee osteoarthritis could be "yes". Treatments in non-surgical procedure can reduce pain, improve function of joints and may slow down further damage of degeneration.
Through reducing symptoms and maintaining proper joint health, these treatments can potentially allow the patient to delay their surgery for years. This can be helpful for many younger patients who might have to have revision surgeries later on in life if they receive their knees replaced too early. Thus, delaying surgery while still maintaining an active lifestyle could be an extremely good benefit.
Regenerative therapy is not a cure for osteoarthritis. The best results will happen from using it at the right time during the course of osteoarthritis. Patients with advanced "bone-on-bone" arthritis, or severe deformity or major destruction of the joint, are likely to receive less benefit, and are likely to still need surgical treatment.
Mentioned below types of individuals are the most appropriate candidates for regenerative therapy:
A thorough clinical examination, advanced imaging studies and a discussion with an orthopaedic physician will help you determine your candidacy for these procedures.
Regenerative medicine alone does not constitute a 'solution,' rather it is one component within a larger framework of managing osteoarthritis. Other equally important aspects of osteoarthritis treatment include: Weight Management, Muscle strength development, Physical therapy, Activity Modification and Nutritional Support.
As every patient will have different presenting conditions, the way treatment options are determined will depend on the level of severity of arthritis, individual goals, age, and general health.
The field of regenerative orthopedics is evolving rapidly, offering hope to patients looking for alternatives between conservative care and surgery. While non-surgical treatments are not miracle cures, they represent valuable tools that may help selected patients manage symptoms, improve quality of life, and delay the need for joint replacement.
As research continues to advance, regenerative medicine is expected to play an increasingly important role in personalized orthopedic care. For patients struggling with knee osteoarthritis, exploring these options early may provide an opportunity to preserve joint function and remain active for longer before considering surgery.
