Navigation Links
Arthritic knees, but not hips, have robust repair response

DURHAM, NC -- Researchers at Duke University Medical Center used new tools they developed to analyze knees and hips and discovered that osteoarthritic knee joints are in a constant state of repair, while hip joints are not.

"This suggests the knee has capacity for repair we didn't know about and the main treatment strategy probably would need to focus on turning off the breakdown of knee tissue," said Virginia Kraus, M.D., Ph.D., professor of Rheumatology and Immunology at Duke. "I was hugely surprised to find this."

This suggests that knee and hip osteoarthritis may need different treatment approaches, Kraus said.

Perhaps the natural repair response would be sufficient to lead to a reversal or halting of the disease process in the knee if the joint breakdown could be halted, Kraus said.

"At least with the knee you've got an ongoing repair response that we didn't appreciate until now," Kraus said. "If you could capitalize on that and turn off the degradative (breakdown) processing you might have some good effects."

The findings, published in the Journal of Biological Chemistry on Friday, Feb. 10, suggest that for hips, however, turning off the degenerative process might not be enough. The hips would need a treatment to both turn off of the degenerative process as well as stimulate factors that could help to begin repair.

The knee is very accessible for injections, so it would make sense to inject the knee with agents that could turn off the degradative processes, and these could be delivered periodically with close monitoring, Kraus said. "That seems like a very viable strategy."

A number of treatment strategies are being tested in clinical trials to turn off the joint breakdown processes, and Kraus is hopeful that this approach will lead to treatment breakthroughs for osteoarthritis.

A cocktail of drugs might be needed for the hip, however, both to turn off the degradation and to stimulate the right type of reparative elements.

"I am speculating that a single agent would work for the knee," Kraus said.

The findings about the knee were shocking to her, because the literature for years had compared the knee and ankle. Scientists knew the ankle was resistant to osteoarthritis, but the knee was very susceptible.

The thinking was that the ankle joint bones fit together well, like a ball in a socket, so the joint cartilage is less likely to degrade, while the knee joint bones fit less well together and require tissue, like the meniscus, to create a better fit so knee cartilage is more likely to degrade.

"What we found is startling, because the hip joint also has a ball-in-socket structure yet it degrades and fails to mount a strong repair response," Kraus said. "We think this means that joint congruency alone cannot explain the difference in the repair response of joints, so there is more to learn."

Kraus and her team discovered a biomarker that is a measure of an altered (deaminated) protein, called D-COMP. In the circulation it signals hip degeneration and in cartilage it provides insight into the repair response of joint tissues. Kraus said this is the first biomarker specific to a particular joint site, and may be developed into a monitoring tool for hip-joint breakdown.

The next step is to understand the reasons for the difference between knees and hips and also to use the new tools to analyze the ankle for its level of repair response.

"Why is the ankle less susceptible than the knee to osteoarthritis?" Kraus asked. "Can we develop other tools to be specific indicators of joint health for other joints in the body?"


Contact: Mary Jane Gore
Duke University Medical Center

Related medicine news :

1. Weight loss improves knee pain from common arthritic condition, study says
2. Rotten eggs gas and inflammation in arthritic joints
3. Alcohol consumption lowers risk of developing several arthritic conditions
4. Electromagnetic Pulses May Stem Arthritic Knee Pain
5. Bursitis a common cause of painful hips, knees, heels and elbows
6. Non-verbal clues guide doctor-patient relationships, clinical judgments, U-M study finds
7. Worrying can impact interpersonal relationships, study finds
8. Chips, Fries, Soda Most to Blame for Long-Term Weight Gain
9. Monitoring wear in helicopters -- and hips, knees and ankles, too
10. Friendships, family relationships get better with age thanks to forgiveness, stereotypes
11. NAMI Launches Social Networking Site for Young Adults: Mental Health, Finances, Relationships, Music and More
Post Your Comments:
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... ... health policy issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, ... work on several important health care topics including advance care planning, healthcare costs ...
(Date:6/25/2016)... ... 25, 2016 , ... First Choice Emergency Room , the largest network ... the Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased ... location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/25/2016)... ... 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, whether it’s ... setting the bar too high can result in disappointment, perhaps even self-loathing. However, those ... goal. , Research from reveals that behind the tendency to ...
(Date:6/24/2016)... ... , ... Marcy was in a crisis. Her son James, eight, was out of control. Prone ... physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If ... at my other children and say he was going to kill them. If we ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San ... Society and the Road To Recovery® program to drive cancer patients to and from ... adults to ensure the highest quality of life and ongoing independence. Getting to ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 2016 Dublin ... addition of the " Global Markets for Spectroscopy ... This report focuses on the ... review, including its applications in various applications. The report ... includes three main industries: pharmaceutical and biotechnology, food and ...
(Date:6/24/2016)... Research and Markets has announced the ... Tests" report to their offering. ... The World Market for Companion Diagnostics covers the ... analysis in the report includes the following: ... Kits) by Region (N. America, EU, ROW), 2015-2020 , ...
(Date:6/23/2016)... HOUSTON , June 23, 2016  MedSource ... platform as its e-clinical software solution of choice.  ... the best possible value to their clients by ... nowEDC.  The preferred relationship establishes nowEDC as the ... pricing for MedSource,s full-service clients.  "nowEDC has long ...
Breaking Medicine Technology: