Cartilage repair

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jooms
jooms Member Posts: 39
edited 13. Sep 2019, 20:01 in Living with arthritis
Chondroblasts and osteoblasts repair cartilage and bone. Why, therefore, joint replacement?

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  • stickywicket
    stickywicket Member Posts: 27,713
    edited 30. Nov -1, 00:00
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    My hips and knees clearly hadn't read the medical textbooks :wink:
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • stellabean
    stellabean Member Posts: 307
    edited 30. Nov -1, 00:00
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    I think that the damage reaches a level where even they can't cope.
  • jooms
    jooms Member Posts: 39
    edited 30. Nov -1, 00:00
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    Could it be that continual inflammation of joints through overuse enhance catabolic effects on the cartilage? In other words, the cartilage is not getting opportunity for repair.
  • crinkly1
    crinkly1 Member Posts: 156
    edited 30. Nov -1, 00:00
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    I am not a Physiologist - just did a simple course of human physiology as part of my professional training many moons ago, so I may be barking up the wrong tree but I have just googled your question as I am unfamiliar with the term you use and found an article that might make more sense to you than to me.

    From Journal of Cell Communication 25th March 2017 an article seems to say that Fibroblast Growth Factor produced by chondrocytes cultured from OA patients indicates insufficient cartilage regeneration.

    This suggests a possible breakthrough into the nature of OA that might lead to more effective future treatment but it sounds as though there is a long way to go with this research.

    As I know from trying to find answers for myself when my OA didn't act like the simple condition it's often thought to be, it has long been admitted that very little is known about the causes and behaviour of OA and that long-standing assumptions, eg 'wear and tear' are inadequate as descriptions of most forms of the condition. (I got as far as being diagnosed by a professor of Rheumatology as having inflammatory Nodal OA but after being recommended to a very useful Pain Management Programme, I was referred back to my GP for long term management and have remained so for nearly 30 years.)

    I Hope you find the sort of information you are seeking via research documents - some are accessible via Versus Arthritis who encourage and fund a number of major projects.
  • stickywicket
    stickywicket Member Posts: 27,713
    edited 30. Nov -1, 00:00
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    jooms wrote:
    Could it be that continual inflammation of joints through overuse enhance catabolic effects on the cartilage? In other words, the cartilage is not getting opportunity for repair.


    That makes sense to me though I'd guess other things come into play too ie the more 'balanced' and 'even' our joints are genetically and the more evenly we wear them the less lkely they are to deteriorate and the more easily they can repair themselves though even the best will reach a point where they can't. But this is purely guesswork.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • jooms
    jooms Member Posts: 39
    edited 30. Nov -1, 00:00
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    "Wear and tear" and " degenerative" are the common use terms to describe unknown cause and unhopeful prognosis of osteoarthritis.
    I feel the problem is physiological and therefore this is where the treatment should be directed - ie repair rather than replace.
  • stickywicket
    stickywicket Member Posts: 27,713
    edited 30. Nov -1, 00:00
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    To the best of my knowledge, cartilege repair is in its infancy. We had a member who sent thousands of pounds going to USA for it but it did nothing for his knee.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • crinkly1
    crinkly1 Member Posts: 156
    edited 30. Nov -1, 00:00
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    Hello again jooms.

    I don't think anyone on the forums is qualified to enter into a debate with you.

    All I can say for sure is that the pot of money which funds research into effective treatments for OA is completely different from the pot of money available for joint replacement operations so there is no competition between them.

    At present, as for the autoimmune versions of arthritis, both are much needed but, hopefully, the day will come when effective treatment options for all will bring to an end the necessity for any surgical interventions.

    Meanwhile, although we know there are occasional unforeseen failures and that surgery is better at reducing pain than at giving back a full range of movement, many of us are immensely thankful for the skill of orthopaedic surgeons and the extra quality of life we have received from their work. We also know that it is our responsibility to look after those implants so they become cost-effective at a time when money for all aspects of the NHS is limited.

    I don't know exactly what you want to discuss nor do I completely understand the physiology underlying the current search for treatment so I can't add anything to my previous suggestion that you access research reports online. If you are not satisfied with your findings from those I'm not sure who you could contact for more information.

    It may be a matter of accepting an imperfect situation (in an imperfect world) in which dedicated medical scientists are doing their best according to the resources at their disposal and relative to the demands of many other debilitating and incurable diseases.
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