| lor: #ffffff;" /> | | | | people who are overweight as well as to manage |
| Arthritis is a growing health concern. The most | | | | arthritis at earlier stages… the health care |
| common form of arthritis-osteoarthritis (OA)- is | | | | community should be prepared for this upcoming |
| increasing in prevalence coincident with the Baby | | | | demand of surgical loads and its economic burden on |
| Boomer surge into late middle age. It is estimated that | | | | government and private insurance systems." |
| OA affects more than 20-30 million Americans. By the | | | | These sobering statistics point towards the need for |
| year 2030, that number will probably double. | | | | therapies designed to prolong the life of cartilage and |
| This form of arthritis is also prevalent among the | | | | possibly to regenerate new cartilage. While the thrust |
| overweight—which describes nearly 65 percent | | | | of research until recently has been to evaluate drugs |
| of our nation's adult population. | | | | that might have disease-modifying potential, clinical trial |
| While the treatment of end-stage OA of | | | | results have been disappointing. |
| weight-bearing joints such as the hips and knees has | | | | In addition, stop-gap measures such as glucocorticoid |
| been enhanced by surgical joint replacement | | | | (“cortisone”) and viscosupplement |
| techniques, joint surgery also has its many downsides | | | | (lubricant) injections may not provide long-term relief. In |
| including complications related to the procedure, | | | | addition, glucocorticoids led to more cartilage |
| complications arising from anesthesia, and the hefty | | | | deterioration. |
| price tag associated with the procedure which is a | | | | However, a new approach- ironically, borrowed from |
| drag on the healthcare system. | | | | the veterinary sector- shows great promise in the |
| A recent study done by researchers at Florida | | | | possibility of cartilage regeneration. |
| International University analyzed increases in surgeries | | | | Stem cells are pluripotential cells, meaning they are |
| and costs between 1997 and 2004. The April 2008 | | | | capable of differentiating into any type of cell in the |
| issue of Arthritis Care & Research presents | | | | body, given the right circumstances. Orthopedic |
| eyebrow raising numbers that conclude with the | | | | surgeons have been interested in designing tissue |
| author’s contention that "the burden resulting | | | | scaffold techniques to help preserve cartilage. |
| from hip/knee joint replacement is not only substantial | | | | However, the procedures are cumbersome and |
| but also increasing at a steep rate." | | | | require recuperation periods of between 6 and 12 |
| Among the findings include: | | | | months. |
| • In 2004, approximately 431,485 primary knee | | | | It is now possible to harvest a person’s own |
| replacements were performed—a 53 percent | | | | stem cells by using a small gauge biopsy needle |
| increase from the year 2000. 225,900 primary hip | | | | inserted into the iliac crest (back of the pelvis). Stem |
| replacements were performed in the | | | | cells are then concentrated in a process termed Bone |
| US—marking a 37 percent increase for the | | | | Marrow Aspirate Concentrate (BMAC). At the same |
| same period. | | | | time, platelet rich plasma is obtained from the |
| • In 1997, about 60 percent of primary hip | | | | patient’s whole blood. Platelets are cells in the |
| replacements and 69 percent of primary knee | | | | blood that contain multiple growth and healing factors. |
| replacements were performed on individuals between | | | | A medium gauge needle is then inserted into the hip or |
| the ages of 65 and 84 years. Although elderly patients | | | | knee and used to “irritate” the cartilage |
| remained the main recipients, the number of joint | | | | and adjacent tendons to stimulate an inflammatory |
| replacement surgeries among the middle-aged, patients | | | | response. Inflammation is the body’s response |
| between 45 and 64 years, increased | | | | to injury and is the first stage of healing. The stem cells |
| excessively—71 percent for hip replacements | | | | and platelet rich plasma are then injected into the joint |
| and 83 percent for knee replacements—in 2004. | | | | and the patient is placed at limited weight-bearing for |
| • Between 1997 and 2004, the hospital charges | | | | one week. |
| for joint replacements, both primary and revision | | | | Follow-up imaging studies including magnetic resonance |
| surgeries, increased faster than the rate of inflation. | | | | imaging and diagnostic ultrasound have confirmed the |
| While Medicare continued to provide the principal | | | | re-growth of cartilage in small uncontrolled studies. |
| source of payment, compared with other sources of | | | | These observations are consistent with the larger |
| payment, the relative burden decreased. The burden | | | | scale controlled studies seen in the veterinary literature. |
| on private insurance more than tripled in that 7-year | | | | Patient selection is important in that patients over the |
| span—from $1.1 billion to $3 billion for hip | | | | age of 60 tend to have “senescent |
| replacements and from $1.46 billion to $4.64 billion for | | | | chondrocytes.” This means their cartilage cells |
| knee replacements. | | | | are older and less responsive to stem cell stimulation. |
| According to the research, led by Dr. Sunny Kim, | | | | That is not meant to entirely exclude patients in their |
| ”if current trends persist, nearly 600,000 hip | | | | 60’s. A patient who is physically active, at ideal |
| replacements and 1.4 million knee replacements will be | | | | weight, and is interested in remaining so, might be a |
| performed in the year 2015. | | | | much better candidate than a 50 year-old couch |
| Dr. Kim and colleagues stressed the need for "public | | | | potato. |
| health education …to reduce the proportion of | | | | |