Background – Osteoarthritis


It’s 2021, and treating osteoarthritis still poses a challenge.

Vastly simplified, osteoarthritis involves loss of cartilage in the joints such that the two faces of a joint can no longer slide smoothly over each other. This might help in understanding the complaint as described in more detail here, but there’s a lot more to it in reality. Knowledge of the various factors involved in developing symptoms of osteoarthritis plays a major role in devising a treatment plan to relieve the symptoms of an arthritic joint.

Lifestyle choices may have some effect

Osteoarthritis develops continuously with age and is a sign of wear and tear; however, we may be able to influence the course of the disease to some degree in our behaviour. Factors such as genetic predisposition, diet, accident injury involving the joint, imbalanced posture or gait, chronic stress on the joint or lack of movement may contribute to the development of arthritis, although this list is far from exhaustive.

Slow development

Osteoarthritis usually develops slowly and is an insidious joint disease with symptoms often only becoming noticeable in later stages of development. In some cases, clinical examination or x-rays may reveal osteoarthritis before it becomes apparent to a patient. On the other hand, we also often have patients with joint problems but no conclusive clinical diagnosis of osteoarthritis.

Contrasts in gait control

A 2016 study on gait control performed by orthopaedic surgeons at Dalhousie University, Halifax, Nova Scotia demonstrated clear differences in movement patterns amongst patients with moderate osteoarthritis; half the patients felt symptoms, the other half were able to walk without complaint. Gait patterns showed statistically significant differences leading to improper weightbearing on the leg in symptomatic patients.

Asymptomatic and symptomatic individuals with the same radiographic evidence of knee osteoarthritis walk with different knee moments and muscle activity – Astephen, JLA,  Stanish, WD, Hubley‐Kozey, CL; 2017 – Journal of Orthopaedic Research – Wiley Online Library.

Symptom relief, weightbearing improvement

Treating osteoarthritis begins with providing symptom relief. Treating the symptoms usually includes improving weightbearing issues that would otherwise contribute to a further progression of the disease. Symptom-free, coordinated weightbearing patterns have been shown to prevent further progression even if they seem rather extreme at first glance.

Schuetz, U, Billich, C, Changes of Cartilage Surface in Knee, Ankle, and Hindfoot Joints in Ultra-endurance Runners during 4.487 km Trans Europe Foot Race Measured by Mobile MRI on a Truck.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 – December 2, 2011 ,Chicago IL.

Achieving sustainable resilience

Orthobiological treatment aims towards not only improving the joint, but also addressing the entire symptom profile affecting the joint, its surrounding tissues and joint control towards a lasting positive outcome with resilience and reduction or complete relief of symptoms. In so doing, it is possible to achieve long-term effectiveness of treatment. Current data from more than two thousand patients orthobiologically treated for diagnosed osteoarthritis with knee involvement have shown this to be achievable with effects still evident after four years.

Pain reduction within a month

[Patient Outcome Data – Regenexx]. An increasing phenomenon has become apparent, and our observations bear this out, that symptoms may become noticeably less within a month, and continue to improve gradually after that. Joint function – joint control as experienced by a patient – and general satisfaction with the changes brought on after treatment increase significantly in the first three to six months after treatment, with gradual improvement continuing afterwards. These positive long-term outcomes have been reproduced in other joints.