For anyone suffering with osteoarthritis in their knee, viagra the options for improvement are limited. There is no cure for the condition and patients are advised to lose weight. In extreme cases, illness where the arthritis is disabling, store joint replacement is offered. But now there is hope for those who think they just have to put up with the pain. Scientists are testing whether a cocktail of stem cells - including some from the hip - could not only halt the damage osteoarthritis causes to the knee, but may ultimately do away with the need for surgery, Daily Mail reports.
Osteoarthritis begins with wear to the cartilage - the strong, flexible material in the joints that allows the bones to glide over one another and move easily.
Often there can be a minor injury that is the initial cause, but cartilage does not heal well and so the condition ultimately gets worse.
Since the 1990s, cartilage cells, also called chondrocytes, have been used to repair small areas of damage. They can be taken from one area and transplanted to another in a graft, or taken from a donor. Another option has been to grow the cells in the laboratory and re-introduce them to the knee.
While effective, these treatments are not suitable for advanced cases of osteoarthritis, where areas of wear are large.
Scientists have also started testing stem cells - master cells that grow into other tissues - to see if they could regenerate the damaged cartilage. The best answer could be a combination of the two. In the new trial about 100 people with early signs of osteoarthritis in the knee will be given stem cells, cartilage cells or a combination of the two - without being told which they are having.
"No one knows if stem cells, chondrocytes, or the combination is best," says Professor James Richardson a consultant orthopaedic surgeon who is helping to run the trial at the Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust in Oswestry, Shropshire.
"For small patches of cartilage damage chondrocytes work well - with 80 percent of patients who have this treatment showing improvement. However they don't work well for bigger areas or where there are two surfaces of cartilage that have worn down. There is some evidence that combing these cells (stem and cartilage) is the best option. If you grow the two together in a laboratory, the stem cells seem to help the chondrocytes. Stem cells have a bit of an anti-inflammatory action - and when you put just chondrocytes in there is often some inflammation left - and it may be that the stem cells turn into cartilage cells as well."
Those on the trial will first have chondrocytes extracted from the knee and stem cells taken from the bone marrow in the hip, under local anaesthetic.
These cells are then left to increase in number in a laboratory. A few weeks later, surgeons will open the knee joint at the front. The cells will be inserted into a pouch stitched into place around the area that is damaged.
The patient will spend three days in hospital and will have physiotherapy for six months.
The first to take part is Robin Griffin who had the procedure six weeks ago. Robin, 43, from Ruthin in North Wales, had suffered with problems with his right knee after fracturing it during a rugby match in his early 20s.
"It never recovered its strength or muscle bulk," says Robin, a site manager at a public school.
"I couldn't run any more than 50 yards as the knee would seize and often fluid would build up at the back of it. I lived with it and did the best I could until about four years ago as my knee was getting in the way of the sports I really enjoy. I could no longer go out on my mountain bike as my knee would stiffen up and on a week's skiing holiday I could only actually ski for about three days because my knee was too painful."
Surgeons tried cleaning out his knee - a process called an arthroscopy - but it didn't help. "It was still locking up and filling with fluid. I could walk OK but couldn't be as active as I wanted to be."
When Robin was offered the chance of going on the trial he was happy to take part. "The other option was I wait ten years and have a knee replacement," he says. After the operation he was in hospital for three days, on crutches for two weeks and has regular physiotherapy.
"I'm still hobbling and it's going to be a while - maybe 12 months - before I am fully recovered. The hope is that this is going to get me active again - I can't wait to go skiing or road biking again."
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