Can osteoarthritis be prevented?
"That's a question I'm often asked," replied the doctor."Given the current lack of understanding of the mechanisms involved, the answer for now is probably no, but there is a lot of research going on with the goal of changing that.
"One fascinating approach is to find ways to speed up the cartilage repair process. A group of hormone-like chemicals—called cytokines—secreted locally in joints influences the maintenance of cartilage, suggesting that it may be possible to promote cartilage repair using one or some combination of these chemicals. Although no such treatment is ready for investigation in humans as yet, the concept is clearly promising.
"A more mundane approach," the doctor noted,"might be to reduce the wear-and-tear process by maintaining appropriate body weight and minimizing activities that are thought to damage cartilage.The role of diet beyond appropriate weight maintenance is controversial. For example, vitamin C, once considered to have protective capability, now appears to increase the severity of osteoarthritis of the knees at high doses, that is, more than 500 milligrams daily.
"On the mechanical side, a great deal of research has gone into developing an understanding of the forces that are exerted on the cartilage surfaces in a weight-bearing joint like the hip or knee during walking, running, twisting, carrying, climbing, and other physical activities. Since the actual weight-bearing surface is small—less than a square inch in a knee, for example—this translates into hundreds of pounds per square inch, with peak pressures in the tons with certain kinds of motion. It's no wonder that these surfaces can break down over time.
The doctor added,"A third approach might be to supply the building blocks of cartilage for the body to incorporate without having to synthesize them from scratch. That is the theory behind the use of such agents as glucosamine and chondroitin sulfate, which are biochemicals important in the structure of cartilage and other connective tissue. Although there is little evidence that taking these substances by mouth has any benefit in cartilage maintenance, they do provide symptomatic benefit for some people with osteoarthritis, and they appear to be safe to use. On the other hand, a recently published Italian study suggests that there may actually be some slowing of the progression of osteoarthritis of the knees in people who take glucosamine. Clearly, further study of this issue is needed before we can determine the value of this approach."
Stella then said,"I think I know a few people with osteoarthritis. How common is it?"
"That's a question I'm often asked," replied the doctor."Given the current lack of understanding of the mechanisms involved, the answer for now is probably no, but there is a lot of research going on with the goal of changing that.
"One fascinating approach is to find ways to speed up the cartilage repair process. A group of hormone-like chemicals—called cytokines—secreted locally in joints influences the maintenance of cartilage, suggesting that it may be possible to promote cartilage repair using one or some combination of these chemicals. Although no such treatment is ready for investigation in humans as yet, the concept is clearly promising.
"A more mundane approach," the doctor noted,"might be to reduce the wear-and-tear process by maintaining appropriate body weight and minimizing activities that are thought to damage cartilage.The role of diet beyond appropriate weight maintenance is controversial. For example, vitamin C, once considered to have protective capability, now appears to increase the severity of osteoarthritis of the knees at high doses, that is, more than 500 milligrams daily.
"On the mechanical side, a great deal of research has gone into developing an understanding of the forces that are exerted on the cartilage surfaces in a weight-bearing joint like the hip or knee during walking, running, twisting, carrying, climbing, and other physical activities. Since the actual weight-bearing surface is small—less than a square inch in a knee, for example—this translates into hundreds of pounds per square inch, with peak pressures in the tons with certain kinds of motion. It's no wonder that these surfaces can break down over time.
The doctor added,"A third approach might be to supply the building blocks of cartilage for the body to incorporate without having to synthesize them from scratch. That is the theory behind the use of such agents as glucosamine and chondroitin sulfate, which are biochemicals important in the structure of cartilage and other connective tissue. Although there is little evidence that taking these substances by mouth has any benefit in cartilage maintenance, they do provide symptomatic benefit for some people with osteoarthritis, and they appear to be safe to use. On the other hand, a recently published Italian study suggests that there may actually be some slowing of the progression of osteoarthritis of the knees in people who take glucosamine. Clearly, further study of this issue is needed before we can determine the value of this approach."
Stella then said,"I think I know a few people with osteoarthritis. How common is it?"
