Managing osetoarthritis

Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis

“…Non-steroidal anti-inflammatory drugs (NSAIDs) Analgesic effects; reduction in pain, stiffness, swelling Often inadequate symptom relief; potential for liver damage in overdose; potential for ulcer and kidney disease; potential for bleeding and vascular events; can cause allergies; effectiveness is dependent upon patient compliance; will not reverse cartilage damage [4][5][6][7][8] Physical activity/therapy Can improve flexibility, range of motion, and function of joint; can provide pain relief; strengthens muscles around the joint; targets obesity, the most important modifiable risk factor for OA Often poor patient compliance; pain/symptom relief is often not enough for patient to adhere to the regiment; will not reverse cartilage damage [9][10][11][12] Opioids Provide pain relief Usefulness in the long-term is limited; Increased risk of adverse events (fractures, cardiovascular events, depression, addiction, overdose, mortality); numerous side effects; will not reverse cartilage damage [9,[13][14][15] Intra-articular injections Hyaluronic acid injections can provide pain relief and improved function that can last over 8 weeks; corticosteroid injections can provide effective short-term pain relief and improved function Injections must be performed in a doctor's office; injections done more than once every 4 months can result in cartilage and joint damage and increase the risk of infection; hyaluronic acid injections show varying efficacy; neither type of injections will reverse cartilage damage [9,[15][16][17] Surgery Total joint arthroplasty can potentially provide permanent pain relief and improved mobility; arthroscopic irrigation and debridement can offer pain relief Many joints do not respond well to total joint arthroplasty; surgery is expensive for patients; increased risk of infection and invasive trauma; arthroscopic procedures do not provide long-term benefits [9,15,17,18] Embryonic stem cells (ESCs) Can undergo self-renewal and are pluripotent; can differentiate into chondrocytes; unlimited proliferative potential; induce cartilage repair in animal models Risk for teratoma formation, tumorgenicity, and immunogenicity; often require mouse fibroblasts to support cell growth, limiting human application; ESCs will likely never be used due to their ethically controversial nature; possibility of heterogeneous population of cells upon injection in patient;…”

Research Article Improvement in orthopedic outcome score and reduction in IL-1β, CXCL13, and TNF-α in synovial fluid of osteoarthritis patients following arthroscopic knee surgery.

“…Arthroscopic knee surgery has become a key technique for KOA diagnosis and treatment since its first use in the 1960s, owing to its benefits of less trauma, quicker recovery, fewer complications, and lower cost compared wti conventional surgery (Dulay et al, 2015;Yu and Hunter, 2015;Zengini et al, 2016). In arthroscopy, the joint cavity can be washed out, removing pain-causing inflammatory mediators, relieving swelling, and extracting cartilage and synovial tissue debris.…”

Effect of Bridging Exercise Interventions on Pain Reduction In the Elderly with Knee Osteoarthritis

“…Management of Osteoarthritis in dealing with pain includes pharmacological and non-pharmacology with a focus on preventing disease and preventing the severity of the disease. Handling of non-pharmacological osteoarthritis can be in the form of weight regulation, lifestyle changes and physiotherapy actions with modalities and therapy for muscle strengthening exercises, one of which is bridging exercise [16,20,21,22]. Currently bridging exercise is more widely used to restore muscle around the lumbar vertebrae and pelvic column, especially stroke patients to train postural balance for stroke patients [23], while treating pain in OA patients is still rare.…”