Osteoarthritis… a dilemma. A solution found with stem cells?

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Osteoarthritis… a dilemma. A solution found with stem cells?



Osteoarthritis (OA) is A HUGE DILEMMA.
Why? Because it the most common form of arthritis and affects approximately 28 million Americans. And that number is going to explode with the Baby Boomers getting older.
While it was initially viewed as a “wear and tear” phenomenon, it has become quite clear that it is a disease that is multifactorial in its development. It is not a benign disease because, in addition to the pain, OA leads to functional disability as well as interference with activities of daily living. Eventually, though, it is the pain that brings the patient to the physician.
The joint is a dynamic structure where anabolic (building) activities are counterbalanced by catabolic (destructive) activities.
With OA, the catabolic activities gradually overtake the anabolic ones. While there are attempts at repair, these attempts are dysfunctional, leading to the formation of bony spurs, called osteophytes.
There are three major risk factors for the development of osteoarthritis. They are genetic (usually a family history is prominent), constitutional (obesity in the case of OA of the knee, and aging), and finally local components (injury, ligamentous laxity, congenital abnormalities).
The development of osteoarthritis starts with an initial injury to cartilage. Cartilage consists of cells called chondrocytes that sit inside a “soup”, a matrix, which consists of collagen and proteoglycans.
The injury may trigger an inflammatory response leading to the synthesis of cartilage matrix degrading enzymes, produced by chondrocytes. Over time, the catabolic activities override anabolic activities and abnormal repair mechanisms.
The end result is the formation of osteophytes, while cartilage continues to degrade.
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