Can you reverse knee osteoarthritis?
And welcome to the One Care Medical Center one of Coimbatore’s fastest growing orthopedic hospital, My name is Dr. Abdul Salam and I am a full-time orthopedic surgeon at OCMC.
In today’s short blog post we are going to answer one very important question I keep getting from my patients
“Doctor, can you reverse knee osteoarthritis?”
Osteoarthritis is a degenerative joint disease characterized by the classical joint degeneration, which its main central feature.
Osteoarthritis is exceedingly common and affects over 1 in 8 individuals on average per year. These numbers, of course, increase drastically after 50 years of age.
Most people assume osteoarthritis occurs as a natural part of the aging process. This is believed to occur due to the routine joint wear & tear. However, this is not always true!.
Recently published studies have found that to a certain extent, it is possible to halt the progression of degenerative osteoarthritis. More interestingly, a spontaneous halt in disease progression has been recorded in a few patients. A good example may be ‘juvenile arthritis that can be halted by intensive physical therapy and medications
Electro-mechanical stimulation of chondrocytes can in effect have some significant healing effects by mechanisms we do not fully understand.
Chondroprotectants in Osteoarthritis:-
One interesting medication that has been found to have some benefit in patients with osteoarthritis are the group of drugs called Glycosaminoglycans (GAGs). GAG’s actually forms the structural components of connective tissue as well as major joints.
A commonly uses GAG medication in clinical practice is Chondroitin Sulphate. Chondroitin sulfate work by probably directly stimulating chondrocyte repair process.
More importantly though, rather than just using analgesics and other combination painkillers for treating Osteoarthritis, we can now use chondroitin sulfate (and thereby avoid the long-term adverse effects of analgesic medications).
Despite the fact that analgesic therapy improves symptoms of osteoarthritis, studies have not found benefits to last very long.
Interestingly, a few clinical trials that compared conventional analgesic therapy vs. chondroitin sulfate therapy found that over 50% of patients were able to return to normal activities as compared to 20% in the analgesic group.
GAG treatment although not 100% effective, was definitely able to slow down disease progression.
The dose at which a clinical benefit of GAG’s where found was roughly 1 to 1.5 gm per day on average. Numerous studies found a decrease in terms of pain scores, and also in terms of improved joint function.
GAG also has a clear advantage in that, the side effect profile of the drug is also minimal and high oral doses can actually be administered quite safely.
Numerous other chondroprotective agents like Vitamin – C, alpha-tocopherol and Vitamin E have also been administered to patients in varying doses. Most studies with these agents reported some benefit in terms of joint range of motion improvement, decreased pain scores and improved workability.
Summary of findings:-
A growing database of studies have suggested that GAG’s can definitely help improve joint function. GAG’s may work through a variety of different mechanisms. But one cannot deny the fact that ‘they exert some degree of therapeutic benefit’
I hope you enjoyed reading this article. Please share this with all your friends and loved ones.
- Roos EM, Dahlberg L. Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four‐month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis & Rheumatism. 2005 Nov;52(11):3507-14.
- Pavelka K, Gatterova J, Gollerova V, Urbanova Z, Sedlackova M, Altman RD. A 5-year randomized controlled, double-blind study of glycosaminoglycan polysulphuric acid complex (Rumalon®) as a structure modifying therapy in osteoarthritis of the hip and knee. Osteoarthritis and Cartilage. 2000 Sep 1;8(5):335-42.