Shattering the myths about osteoarthritis
Bones and Joints Research over the past decade has changed the way we think about and treat osteoarthritis. As the burden of disease looks set to increase, more research is being carried out to improve patients’ quality of life.
Osteoarthritis is the most common form of arthritis in the UK. According to Arthritis Research UK, around a third of all people over the age of 45 have sought treatment for the condition, which causes episodes of joint inflammation, use-related pain and problems carrying out daily activities. While osteoarthritis can be debilitating, a diagnosis doesn’t necessarily mean the start of progressive problems and for most patients treatment will focus on three core areas: exercise, weight loss and education.
“We often describe osteoarthritis as a condition of tear, flare and repair,” explains Dr Fraser Birell, Consultant and Senior Lecturer in Rheumatology at Northumbria Healthcare NHS Foundation Trust. “In the past patients were often led to believe that if they developed osteoarthritis they’d definitely need a joint replacement. We now know this usually isn’t the case.”
The body is built to repair itself, so when damage to the joints causes discomfort, there are a number of things that patients can do to help the healing process. Contrary to popular belief, recreational exercise won’t exacerbate the problem. In fact, strengthening the muscles around the joint will help to reduce pain and improve function; aerobic exercise does this too and has other benefits for the heart and lungs.
As osteoarthritis is largely a biomechanical condition, losing weight – even if you’re not clinically obese, just overweight – can also help to decrease the stress on joints. Of course, these interventions need to be delivered in the right educational package, so patients don’t suffer in silence and know when to seek further help.
Alongside improved management of the condition, those with severe forms of osteoarthritis are getting the surgery they need. “17 years ago, we predicted the need for hip replacements would increase by 40% over 30 years,” says Dr. Birell. “In reality it doubled over the next ten years. Now around 164,000 people have hip and knee replacements every year, which costs the NHS at least £1billion. This is money well spent, as joint replacement is one of the most effective and value for money operations and is getting cheaper and better, as shorter hospital stays are reducing both costs and complications.”
With an aging population, Dr. Birrell warns that osteoarthritis and other age-associated diseases are a potential “demographic time bomb,” and research is underway to look at alternative therapies that could negate the need for surgery whilst helping patients maintain their quality of life. “A lot of work is being done to understand the inflammatory cascade and how that links to pain and progressive joint damage,” explains Dr. Birrell. “If we can identify patients at greatest risk of progression and intervene earlier we could help them maintain their quality of life, without the need for invasive surgery.”
Currently research is being carried out into repurposing drugs, using agents that can strengthen the bones and developing biological therapies that target a particular inflammatory marker. One area that is receiving considerable attention is the introduction of stem cells via keyhole surgery to regenerate damaged joints and delay the need for joint replacement. Perhaps one of the most surprising therapies being explored is a method that involves holding a damaged knee apart using a frame for around six to eight weeks. The technique, known as knee joint distraction, allows joint tissue to repair naturally and could prove to be highly effective in the treatment of osteoarthritis
Developments over the past decade have undoubtedly improved the lives of countless individuals and with continued investment in new research that looks set to continue.