Every October 12th is World Arthritis Day. Arthritis is one of the most common chronic diseases, there are more than 100 types, of which osteoarthritis is the most common. Osteoarthritis is a degenerative joint disease that affects about 75% of people over the age of 65 worldwide. The cause of this disease is that the cartilage between the two joints is worn down and loses its lubrication and cushioning effect on the joints. When exercising, there is direct bone-to-bone friction at both ends of the joint. Is this not painful? Therefore, this disease will lead to varying degrees of decline in the quality of life of patients, and in severe cases, they may even be unable to walk.
There is currently no cure for osteoarthritis other than pain relievers. But painkillers are only a stopgap measure after all. If we can find a way to regenerate the patient's cartilage, the symptoms can be relieved, and the disease may even be completely cured.
So, can human cartilage regenerate? There is great controversy in the medical community on this issue. Conventional wisdom holds that human cartilage cannot regenerate. One evidence is that there are no capillaries inside cartilage tissue, so it cannot provide the necessary repair cells and nutrients for tissue regeneration.
Another piece of evidence comes from studies of the isotope carbon-14. Danish scientists analyzed carbon-14 levels in samples of human knees replaced by knee replacements over the past few decades and found that those who grew up in the 1950s had the highest levels, and those born before and after Both are low. As we all know, due to the relationship of the Cold War, the superpowers conducted multiple nuclear tests in the 1950s. This trend did not come to an end until 1963 when the Soviet Union, the United States and Britain signed a partial nuclear test ban treaty. Nuclear detonations spew so much of the isotope carbon-14 into the atmosphere that a rare spike in the otherwise low-abundance isotope occurred in the 1950s. This study shows that human cartilage completes its development between the ages of 8 and 13, and thereafter hardly renews it.
Because of these two evidences, patients with osteoarthritis are almost sentenced to "death": almost all regular orthopedic doctors in the world will tell patients that cartilage is non-renewable, and two popular joint health products on the market, glucosamine and cartilage sulfate The drug is just a placebo and has no effect. If the patient really can't stand the pain, he can only choose to install artificial joints, just like a broken tooth can only be fitted with dentures. The problem is that artificial joints often only have a lifespan of 15 to 20 years, after which they have to be re-operated to replace them. If a person develops osteoarthritis in middle age, then he will face two joint replacement operations, and the second will be done when he is very old. The risk is too great.
At the same time, there are still some orthopedic experts who do not believe in evil. They believe that there are living cells inside the cartilage tissue, and it is the fibrin secreted by these chondrocytes that constitutes the main component of the cartilage tissue. die.
Therefore, these scientists have been insisting on finding signs of cartilage tissue regeneration and studying the regeneration mechanism behind it. After years of tireless work, they have good news and bad news.
The good news is that signs of cartilage regeneration have indeed been found, and the mechanism behind it is gradually being understood, which scientists call "dynamic loading". The core of this mechanism is the joint synovial fluid, which can not only provide lubrication, but also replace blood and bring the required nutrients to the cartilage tissue in the joint. The only difference is that synovial fluid is not powered by the heart like blood, and must rely on dynamic processes such as extrusion and expansion of the joint itself to circulate, which is where the name "dynamic loading" comes from. This theory explains why the best way to prevent arthritis is to keep exercising. Only by doing so can the circulation of joint fluid be accelerated and more nutrients be provided for cartilage regeneration.
By the way, the exercises mentioned here should preferably include weight-bearing exercises. Only in this way can the strength of the muscles near the joints be increased, thereby reducing the pressure on the joints and reducing the pain.
It is a pity that scientists also brought bad news, that is, the regeneration ability of human articular cartilage tissue is very limited, far less powerful than other tissues in the body, this is why middle-aged and elderly people will get arthritis, and this disease is so difficult reason for treatment. This is also the reason why the carbon-14 study mentioned earlier came to negative conclusions.
What's more interesting is that Virginia Krauss, an orthopedic expert at Duke University School of Medicine, and others, through the study of the protein synthesis ability of different joints, found that the human ankle joint has the strongest cartilage tissue regeneration ability, followed by the knee joint and the hip joint. Difference. This explains why humans rarely suffer from ankle arthritis and why the incidence of hip arthritis is so high.
The paper, published in the Oct. 9, 2019, issue of the journal Science Advances, is what Krauss calls a "human salamander relic," because salamanders regenerate their limbs most strongly at the ends, closer to the trunk. Portions are relatively poor.
Krauss also found that mRNAs involved in cartilage repair were higher in joints with osteoarthritis than in healthy joints, suggesting that osteoarthritis acts as a switch that activates residual limb regeneration mechanisms in humans. It's just that this mechanism in humans has been severely degraded compared with salamanders, and it is not enough to achieve a complete repair of articular cartilage.
The discovery of a mechanism for cartilage regeneration has inspired a new treatment called "joint traction," which preliminary results have shown to be effective. As the name implies, this method needs to use external force to stretch the joint to both sides, and then insert a wedge in the middle of the joint to maintain a space of about 5 mm between the upper and lower joint surfaces. Synovial fluid will fill this space, providing sufficient nutrients for the cartilage regeneration process. Usually, the whole course of treatment will last for 6 weeks, during which the patient can continue to walk without affecting life.
In the March 2022 issue of Rheumatology, in a paper by Dr. Merlin Jansen, an orthopedic specialist at the University Medical Center Utrecht in the Netherlands, the authors and colleagues used magnetic resonance imaging (MRI) to measure receptivity. The thickness of the cartilage of patients treated with this therapy has generally been increased, and this effect can be maintained for more than 10 years.
In conclusion, human cartilage does have a certain degree of regenerative capacity, but it is often insufficient to cope with the degeneration of joints. Middle-aged and elderly people must exercise more, on the one hand to provide sufficient joint synovial fluid for cartilage regeneration, on the other hand, it can also increase the strength of muscles near the joints, and lose weight by the way to reduce the pressure on the joints. If it doesn't work, you can try this "joint traction" to increase the supply of synovial fluid in the joints and help the cartilage regenerate faster.
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