Sometimes referred to as degenerative joint disease or OA,
osteoarthritis is the most common kind of arthritis and the third most common disease in the U.S. Osteoarthritis occurs when the cartilage that protects and lines the joints starts to deteriorate with age and wear.
People with OA usually experience it in their knees, hands, lower back, and neck. Pain, a popping sensation, redness and inflammation, and a feeling of grinding or heat at the joint are common symptoms. Incidence of OA increases as we age, and, not surprisingly, negatively affects our desire to move around. To avoid painful grinding sensations, people may become more sedentary, leading to a host of other health problems.
Today, OA patients have two options: manage the pain, and if that doesn’t work, undergo surgery to replace the joint. But tomorrow, we hope, is just around the corner.
“Within five years, our goal is to develop a suite of non-invasive therapies that can end osteoarthritis,” says Stephanie Bryant, PhD, of the University of Colorado Boulder. Bryant and her team recently received a $39 million grant to participate in
NITRO, or Novel Innovations in Tissue Regeneration in Osteoarthritis. NITRO is a $1 billion federally-funded research initiative currently racing to develop regenerative therapies for OA–and to make them an affordable option for everyone.
What are regenerative therapies? According to the
Arthritis Foundation, “regenerative medicine aims to stimulate and support the body’s natural healing response,” and we’re going to be hearing a lot more about it in the coming years. Several regenerative therapies are already on the market, and, while still understudied, by many accounts they’re relieving pain and increasing mobility for people with OA.
Prolotherapy
A
prolotherapy treatment involves injecting a small amount of irritant, usually a dextrose solution (yes–that’s sugar water), into the area around the joint. The idea is that when the body senses an unusual substance near the area where cartilage is deteriorating, natural healing takes place in and around the joint as the body directs its attention there.
As an alternative therapy, prolotherapy isn’t FDA approved, and studies have yet to prove its effectiveness. As a result, it’s not covered by insurance. But some studies and patients report improvement in osteoarthritis symptoms in knees after prolotherapy.
Prolozone Therapy
Like prolotherapy, prolozone therapy involves an injection near the joint, and it’s not FDA approved. Prolozone includes more than just sugar water: the injection also delivers anti-inflammatory medication, ozone, vitamins, and minerals to the affected area.
The key difference is the ozone, which, according to
proponents of the therapy, carries several benefits: ozone helps increase blood flow and jumpstart the healing process by stimulating cells to produce more energy. In addition to OA, prolozone is also marketed to help treat wrist and elbow pain, chronic neck and back pain, tendonitis, foot and ankle pain, and more.
Other regenerative therapies for OA include Platelet-Rich Plasma (PRP), Allograft Amniotic Growth Factors, and stem cells. These different therapies may be recommended and provided by a doctor, musculoskeletal specialist physician, orthopedic surgeon, or other therapist.
Eradicating Osteoarthritis this Decade?
The NITRO research initiative provides one major example of the growing promise of regenerative medicine for OA. Drawing on the latest science from regenerative medicine, biomaterials, and biomedical engineering, NITRO’s big question is: “What if we could make our joints heal themselves?”
With funding from the Advanced Research Projects Agency for Health (ARPA-H), the researchers are working at an accelerated pace in
three key areas:
- Regenerating bone through injection or non-invasive surgery
- Regenerating cartilage through injection or non-invasive surgery
- Building replacement joints from human cells
Over 32 million Americans suffer from OA, and the project centers equity in its search for regenerative therapies. All program trials will enroll at least 50% women and be representative of the demographics most affected by OA. Of people with osteoarthritis, 88% are over 45 years old, 62% are women, and 78% are non-Hispanic whites; however, within Black and Hispanic populations, there is a higher rate of OA than within the non-Hispanic white population, according to
Osteoarthritis Action Alliance.
“At the core of this, the goal is to develop a therapy that’s going to be available to all Americans, not just a privileged few,” says Karin Payne, PhD, a Co-Principal Investigator on the Colorado University team, one of five university teams working together in the NITRO program.
And the therapy they’re after would be a real cure: not a replacement joint that only lasts 10 or 20 years, like we have now, but a way for the body to heal itself. People with OA will be eagerly checking back in five years to learn about the NITRO teams’ progress.