Nutritional, metabolic and genetic considerations to optimise regenerative medicine outcome for knee osteoarthritis

Abstract

Knee osteoarthritis (KOA) is a multifactorial degenerative disorder of joints, affecting the world's population over the age of 65 and with a higher prevalence in females. KOA is responsible for many age associated joint problems such as stiffness and pain. Conventional methods for managing KOA such as nonsteroidal anti-inflammatory drugs (NSAID) may not improve pain or alter the disease progression and may have adverse side effects. Non-pharmacological management of OA is fundamental to management of functional limitations and provides effective symptom relief but has not shown that disease progression can be altered. Regenerative medicine is a relatively new approach which aims to induce cellular regeneration and promote self-healing through minimally invasive methods. The use of regenerative medicine slowed the progression of KOA and revealed significant improvements, yet further investigations are required to optimize the outcomes. Nutritional and metabolic aspects such as supplementations, vitamins and minerals were proven to have an impact on the progression of KOA. Genetic variations are rapidly inspected to identify any potential influence of these variations in the predisposition and diagnosis of KOA. Further supporting evidence suggests the potential influence of metabolic, nutritional and genetic aspects in optimizing the outcomes of regenerative medicine in the management of KOA.

Chondroprotection and Molecular Mechanism of Action of Phytonutraceuticals on Osteoarthritis

“…Studies [ 12 , 28 ] show that rosehip berries, ginger root, green tea leaves, turmeric root, pomegranate peel, containing a significant amount of polyphenols and phytoflavonoids, have chondroprotective activity, which positively affects the OA prevention and treatment.…”

“…Pomegranate anthocyanins and polyphenols have an anti-inflammatory effect. It is known [ 12 , 28 ] that high doses of pomegranate juice injected into mice with OA reduced joint damage and promoted proteoglycan preservation. The results obtained in vivo confirm that pomegranate has a positive effect on the cartilage destruction in OA.…”

“…It is known that ginger reduces inflammation and stimulates blood circulation [ 67 , 72 ]. The US Food and Drug Administration (FDA) has recognized the safety of ginger [ 12 , 28 ]. The beneficial effect of using ginger as an alternative to drug therapy in arthritis treatment has been proven.…”

“…They are considered not only as a safe alternative to existing drugs but also as drugs to relieve OA symptoms. Over-the-counter alternatives (dietary supplements and phytonutraceuticals) are used to treat 47% of OA patients [ 12 ]. Recent research has shown that plant flavonoids, polyphenols, and bioflavonoids are naturally occurring compounds found in fruits, tea, spices, wine, and vegetables.…”

Bone Marrow Aspirate Matrix: A Convenient Ally in Regenerative Medicine

“…Popular nonpharmacological strategies usually employ exercise, physical therapy and education, weight loss, physical aids, radiofrequency ablation and—in more severe cases—surgical joint replacement [ 2 ]. Pharmacological options only manage pain temporarily and do not target the disease itself [ 3 ]. Medical experts may typically prescribe a combination of drugs with the sole objective of blocking inflammatory processes.…”