Outside of our initiatives at Regenexx and a few others, it seems that all of the research of which I am aware using stem cells in joints is focused on trying to treat focal defects in cartilage and not degeneration of the whole joint. A focal defect is not unlike a pothole in a Chicago street; the approach is a patch. The challenge in the osteoarthritic joint is not only cartilage regeneration but also the whole structure. Cartilage, capsule, the synovial lining, the inflammatory component, and reversal of a bio-immune process must be addressed. Stem Cells can regenerate cartilage and stem cells are readily available in bone marrow. Bone marrow aspirate concentrate additionally has the potential to act as an effective anti-inflammatory agent, while reversing the bio-immune progression of osteoarthritis.
Recent advances in the understanding of the progression of degenerative arthritis have introduced the possibility of Mechanical Loading as a potential Preventive and Therapeutic Strategy for Osteoarthitis. The laboratory has demonstrated that mechanical loading is an extremely important factor in cartilage well being. Although over use and underuse are risk factors for cartilage degradation, moderate dynamic loading is not only associated with a healthy lifestyle, but they are very important preventive and therapeutic strategies for OA. Such activity suppresses inflammation, inhibits joint breakdown, and enhances joint regeneration. The biochemical explanation is the balance between Interleukin-1 and IL-1 Receptor antagonist (IL-1Ra). It may well be that Mechanical Loading increases IL-1Ra and lessens the presence of IL-1, the latter accounting for cessation of cartilage repair.
The definition of “Moderate” Physical Activity certainly may vary for a particular individual depending on that person’s age, genetics, gender, and physical activity history. This weekend, I ran on Saturday and cycled on Sunday. That may be a bit more than the average. Today, I row the ergometer and strength train. For those less obsessive, a new study funded in apart by the National Institutes of Health, examined whether walking could reduce the risk of functional limitations for people with knee OA. The result: 6,000 steps a day keeps knee OA limitations away. You don’t become inactive because you grow old; you grow old because you become inactive to paraphrase a great intellectual.