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Osteoarthritis


Osteoarthritis is a joint condition causing pain and stiffness in the knee as well as in other joints of the body. This medical condition can be caused due to daily wear and tear that affects the body when the joints are exposed at low impact levels. The day to day activities can affect the joint cartilage and result in breakdown of bone ends causing pain, swelling and difficulty in moving the affected joint. Normally the body repairs minor damages that occur to the cartilage and joint bones. However with osteoarthritis the condition has to be treated externally to ease the pain and swelling of the affected joints.

The severity of osteoarthritis and its symptoms vary in each individual and ranges from mild to extreme pain and stiffness causing a restriction in daily activities. The condition is mostly affected in the knees, hips and small joints of the hands.

Many factors can lead to the development of osteoarthritis including joint injury due to an accident or previous surgery, secondary arthritis, age increase the risk of joint conditions, family history and overweight or obesity. Osteoarthritis is diagnosed by examining the affected joints and symptoms and performs various diagnosing tests which may include an X-rays or blood tests. Osteoarthritis is conventionally treated with painkiller medications, a structured exercise plan under the supervision of a physiotherapist. Depending on the severity of joint damage and factors such as age and overall health condition of the patient, the doctor may recommend Joint Replacement Surgery.

Alternative treatment methods at Beth Yehuwdah Arthritis Centre, Pullad & Daystar Clinic, Alappuzha:

Platelet Rich Plasma in Osteoarthritis: Plasma rich platelet prolotherapy is the recent trend in treating various joint conditions and is designed to stimulate repair of torn ligaments in the affected joint and to reduce swelling and pain caused by the condition. PRP prolotherapy is a combination treatment where PRP is injected into the joint and bursa (cushions around the joint) and dextrose prolotherapy is given to the ligaments of the joint.

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This PRP knee treatment can help a patient to avoid surgery and to overcome the disease condition with minimally invasive injection techniques. The treatment method stimulates the natural immune repair mechanisms of the body and delivers the building block essential to build and replace damaged soft tissues.

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How does PRP work? Blood components are of four major types - plasma, platelets, white blood cells and red blood cells. Platelets assist in clotting and are also the “first-responders” of the body post injury; helping repair an injured region and in building up of new tissue and thereby promoting the healing process. Once platelets contact collagen in damaged tissues, the platelets release various biological growth factors (Table 1 as given below) to promote healing in soft tissues locally. Activated platelets commonly release the following growth factors:

Platelet-Derived Growth Factor (PDGF) Attracts cells of the immune system to the site and stimulates their proliferation. Also shown to assist in healing of ligaments and tendons.
Transforming Growth Factor-ß (TGF-ß) Similar affects as PDGF. It is Secreted by all major cell types involved in healing.
Vascular Endothelial Growth Factor (VEGF) Helps in formation of new blood vessel, thereby increasing vascularity in injured areas.
Fibroblast Growth Factor (FGF) Promotes the growth of the cells involved in collagen and cartilage formation.

Table 1: Various biological growth factors released by PRP when activated

PRP injection delivers a high concentration of autologous (patient’s own) platelets to the knee, hip, spine and/ or other joints where osteoarthritis is present.
Platelets present in the blood are the first responders to an injured area and helps build up new tissues. Introducing high concentration of platelets directly into the joint using PRP injection stimulates the healing process and faster recovery from the joint condition.

Patient Benefits of PRP Prolotherapy:

  1. Minimally invasive treatment method
  2. Almost painless injection technique using very thin needles under local anesthesia
  3. Avoid if not delay Joint Replacement Surgery
  4. Significantly reduces the symptoms associated with osteoarthritis
  5. Reduced risk of adverse events
  6. Repairs and strengthens ligaments improving joint stability.
  7. Safe and effective treatment method
  8. Faster healing and recovery
  9. PRP Prolotherapy results in safe, significant, effective, progressive improvement of knee pain and function.

2) Prolotherapy in Osteoarthritis:

 

Prolotherapy is a natural and cost effective alternative method to surgery. Prolotherapy is an almost painless injection technique under local anesthesia where very thin needles are used to inject high concentrations of dextrose solution (sugar similar to glucose) in to loose and damaged ligaments, tendon and muscle attachments around the osteoarthritic joint. Prolotherapy works by increasing the glucose concentration in the fluid outside the cells. This results in movement of fluid from inside the cells to the outside of the cells thereby shrinking the cells and causing temporary cell damage (hyperosmolar damage). As the cells are temporarily damaged, they release many biosignals to the body which results in stimulation of the immune system of the body to accelerate the inflammatory process locally resulting in increased local blood circulation, fibroblast (fibrous cell) proliferation, ligament regeneration, tightening and repair. Prolotherapy is an effective non surgical treatment method used successfully in osteoarthritis/ degenerative joint disease condition. This PRP knee treatment method has the ability to strengthen the existing intact, but weakened, ligamentous and tendinous structures in the joint. Along with the treatment technique, it is important to perform series of movement and muscle strengthening exercises to strengthen the already weakened muscles due to osteoarthritis joint condition.
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Patient Benefits of Prolotherapy:

  • Minimally invasive treatment method
  • Almost painless injection technique using very thin needles under local anesthesia
  • Avoid if not delay Joint Replacement Surgery
  • Significantly reduces the symptoms associated with Osteoarthritis
  • Reduced risk of adverse events
  • Repairs and tightens ligaments improving joint stability and ease of walking
  • Safe and effective treatment method
  • Faster healing and recovery
  • Prolotherapy results in safe, significant,effective, progressive improvement of knee pain, function and reduction of stiffness.

At Beth Yehuwdah Arthritis Centre, Pullad and Daystar Clinic, Alappuzha we tailor customized treatment plan to treat patients suffering from Osteoarthritis. To know more about osteoarthritis treatment or PRP knee treatment plans and treatment cost, book an appointment now.

Authored by Dr TEJAZ KOSHY JOHN

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Dr. Tejaz Koshy John

Consultant for Orthobiologics, Regenerative & Interventional Orthopaedics

MBBS, MS Ortho (Christian Medical College, Ludhiana), Joint Replacement Fellowship (HOSMAT Hospital, Bangalore), Orthopaedic Trauma Fellowship (Hebrew University Hospital, Jerusalem, Israel)

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