Joint surfaces consist of bone covered with a smooth lining of cartilage. Cartilage is a smooth material that is found throughout your body, and it allows the joint to move freely. When one smooth cartilage surface glides against another, the amount of friction between the surfaces is five times less than the friction of ice gliding on ice!
Individuals who suffer from osteoarthritis, the most common type of arthritis, experience a loss of this cartilage surface. Also known as degenerative joint disease, or wear-and-tear arthritis, osteoarthritis occurs more frequently in older populations, but can also affect younger individuals.
As the cartilage is worn away, the bone becomes exposed, and the unprotected joint surfaces rub against each other. Patients typically experience symptoms as the joint becomes painful and stiff. Treatment has focused on controlling pain, strengthening the muscles around the joint, and ultimately, joint replacement surgery. However, joint replacement surgery is not optimal, especially for younger patients (under 65 years old). New research has focused on attempting to reverse the arthritic process to restore the normal joint.
Why can't the cartilage heal?
Unfortunately for those who have arthritis, cartilage does not regenerate well in the human body. Unlike a damaged bone, which if protected will heal with new bone, cartilage does not simply heal with time. Scientists are unsure exactly why cartilage does not tend to heal well, but there are several theories:
- Cartilage lacks nutrion from blood vessels
Cartilage does not contain blood vessels, and circulation is a critical part of the normal healing process. The absence of a blood supply may suppress the normal inflammatory response associated with healing.
- Cartilage exists in an environment that will not allow healing
Another theory is that synovial fluid, the fluid within joints that bathes the cartilage may be the culprit. The synovial fluid may lack substances needed for healing, or it may contain substances that inhibit healing.
Is there hope for arthritis treatment?
Several new treatments have been used in attempting to alter the slow degenerative process of arthritis. These treatments have provided some encouraging results, but all have a limited focus and all have only been examined in short term studies. Whether or not the studies into these treatments show an actual effect or a normal fluctuation in the course of arthritis is difficult to determine.
- An editorial in the New England Journal of Medicine cautioned "the progression [of] osteoarthritis is sometimes so slow that we delude ourselves into thinking we are doing better than we are." (1)
Excitement over these new treatments has sparked patient interest, and many individuals are understandably willing to try anything. On the following page some of these new athritis treatments are discussed, as well as the pros and cons of these treatment techniques.
Read on for information about new arthritis treatment options...
(1) NEJM Vol. 331, No. 14