Your Body May Be Able to Repair Its Arthritic Joints with Help from Drugs or Surgery

It does not heal. Doctors tell us that when we hurt the flexible tissue that lines our hips, knees and shoulders, or when osteoarthritis erodes it so that our joints hurt when we move. I've heard it before from surgeons who say that there is no blood supply for repair cells to come to an injury site. I thought that a living tissue could not replace damaged cells. According to recent research, the type of cartilage in our joints does not have a great deal of repair capacity. New insights into this ability are raising hopes for treatments that could help heal or protect damaged cartilage.

Imagine a chicken bone with a white coating on it. The majority of it is made up of a mixture of water and fibroblasts pumped out by cells. Virginia Kraus is a rheumatologist at the Duke University School of Medicine. She says that the renewal process is slow. It's true that in adults there isn't a blood supply. Dynamic loading is when stress or weight on the joint causes the fluid in and out of the joint. Exercise is important to joint health. It's through movement that you get the vitamins to your body.

Kraus is part of a small group of scientists who study the turnover in this tissue. She and her team discovered that the production of the repair and regeneration molecule is greater in the ankle than in the knee. Kraus says that the ability to regenerate a lost limb in salamanders and other animals is more robust in the foot than higher up in the leg.

Genetic material associated with repair is more abundant in arthritic joints. Kraus thinks that the program we have is not enough, as osteoarthritis is turning it on in humans. She points out that the ankle is less prone to arthritis than the knee or hip.

There is more evidence that the human body can grow new tissue. A procedure called joint distraction is being tested as a way to promote healing in patients who have bone-on-bone knee arthritis and are too young to be a good candidate for total knee replacement. Prosthetic knees last 15 to 20 years before they need to be replaced. The upper and lower leg bones are separated with an external device for six weeks. The joint space can be opened up. The knee is bathed in fluid without being overburdened because patients are encouraged to walk.

Dutch researchers have shown that the procedure leads to a small increase in the joint's elasticity and less pain, which lasts at least two years and as many as ten in some patients. There are larger clinical trials of the technique that need to be done.

There are new drugs that may slow the loss of cartilage in some patients. Canakinumab, a cardiovascular drug that was tested as a cardiovascular drug and showed a surprising side effect, had fewer joint replacements in recipients than in a placebo group. It's difficult to find drugs that can make a difference because of the slow and uncertain nature of repair.

Strength-building exercise is the best way to strengthen our joints. Conaghan says to walk in a pool. He says that strong quads reduce knee pain regardless of what's going on. Life is all about strength.