The most sensible way to treat arthritis is to stop it in its tracks. Let’s start by focusing on what arthritis is and how it occurs. Understanding the mechanics of arthritic progression will help patients understand the treatment process.
We are specifically talking about osteoarthritis, which is also known as mechanical arthritis. The knee comprises three prominent bones: the upper femur, lower tibia, and the patella (also known as the kneecap). The upper femur bone contacts the lower tibia bone and the patella, and how they contact one another determines how quickly the bone changes underneath the cartilage. Alterations to the bone and cartilage are what determines how long the knee will last.
When functioning with the femur evenly contacting the tibia, the joint load is equally distributed across both sides of the joint. A joint with these characteristics will usually last longer. Patients whose weight is not equally distributed (ie: “bow-legged” or “knock-kneed”) wear their joints out faster because the load is not evenly distributed across the two compartments of the knee. The body responds to this overload by increasing the bone’s strength underneath the cartilage, making it stiffer at contact. Once the bone underneath the cartilage has become stiff, the soft cartilage matrix between the bone fragments, this fragmentation causes little pieces of the cartilage to mix into the joint fluid. Fragmentation of the knee cartilage activates inflammatory cells in the knee, causing further deterioration of the cartilage until it wears down to the bone. This “bone-on-bone” contact is not what causes the pain of arthritis. The response of the inflammatory cells to the fragmented cartilage matrix causes the pain associated with arthritis.
Knowing and understanding this biologic process makes it easier for patients to understand how biologic orthopedic treatments work. There is a broad range of treatments available, and some are highly complementary and very easy to apply. Frequently a visit to a gait expert who makes a shoe insert with a wedged-heel is all that is required, particularly if the disease is caught early enough, just like anything else.
If it has progressed beyond that point, the best option is to pursue an expert in Immunobiologics that can personalize a treatment plan to slow the progression and reverse it by healing the bone. These treatments range from medium to long-term pain relief, and for many, the pain will be eliminated.