Effective new therapy for arthritis

Jun 3, 2004

Kettering researchers have teamed up with Family Orthopedic Associates to study how long a new arthritis therapy can postpone surgery.

Joint fluid therapy (JFT), a new treatment for patients diagnosed with arthritis in the knee joint, is showing great results. In a technique akin to "changing your oil," doctors inject a biological oil into the knee where damaged or disintegrating cartilage allows bone-on-bone contact resulting in arthritis pain.

"The 'bio oil' provides a layer of protection between the bones and helps ease joint pain for most patients," said Dr. Patrick Atkinson, associate professor of Mechanical Engineering at Kettering University. This enables patients and their doctors to delay the need for surgery.

Physicians at Family Orthopedic Associates, in Flint Township, are working with faculty at Kettering University on a study to analyze data on how long JFT allows patients to live comfortably before requiring surgery. The study retrospectively compares JFT patient histories to those of non-JFT surgery patients to analyze time between diagnosis and surgery.

"We're looking for a statistical sample that is meaningful," said Atkinson, "we need to answer the question 'as a treatment option, how do we analyze this effectively?' so it stands up to scientific muster." Atkinson is working with Dr. Norman Walter, M.D., chairman of the Department of Orthopedic Surgery at McLaren Regional Medical Center and a physician at Family Orthopedic Associates.

Other treatments for arthritis include anti-inflammatory drugs that can cause stomach upset, steroid or cortisone injections that can further damage cartilage or joint replacement surgery. "Every time you do joint replacement surgery it involves reshaping the bone," Atkinson said, "and this is stressful on the body. A joint replacement is going to last only about 15 to 20 years. The ideal is that you only do it once, so you want to delay surgery as long as long as possible."

The answer is JFT, which appears not to have the same negative affects as steroids or cortisone. JFT separates bones like cartilage. Cartilage is the cushiony tissue that allows pain free motion in joints. Because it doesn't have nerves, it creates an unfeeling barrier between bones, which do have nerves. When cartilage begins to break down, the result is painful bone-on-bone contact.

The joint fluid therapy itself is a series of three or five injections once per week over three to five weeks. "Typically the patient will elect to have a series of injections once a year," said Atkinson. "Right now the therapy is so new that there are no statistics on how many years patients can delay surgery.

"Some JFT patients have gone on to have joint replacement surgery," he said, "but any day you can delay it is a benefit. It's really a question of quality of life, if you can't walk it has serious consequences on your overall health."

Being able to ambulate is of primary concern for physicians working with patients dealing with obesity or trying to get diabetes under control to improve circulation and facilitate weight control. Genesee County in particular has a higher incidence of arthritis in leg joints, according to Atkinson. "This area had a lot of manual labor and a lot of physical stresses related to work," he said.

"In addition, people in this area tend to have a higher body weight compared to the national average, and higher body weight is the number one predisposing factor to arthritis," said Atkinson, "with a distant second being trauma to the joint. There is also apparently a familial connection, so family history may also play a role."

In the long term, moderate exercise is the best preventative, said Atkinson. "People just need to mobilize their joints. If body tissue just sits it develops disuse atrophy. It's a vicious cycle," he said, "if your leg hurts you don't want to use it, the longer you don't use it the more it will hurt when you do." The old adage "use it or lose it" is true.

"Thechance of a healthier life is better if you use your body physically in some way," Atkinson said. "Anything that burns calories, moves joints or engages muscles will work."

In addition to analyzing the efficacy of JFT, Dr. Walter is conducting a study to obtain FDA approval to use JFT on hip joints. Currently JFT is only available for insurance reimbursement for knees. If Walter's study is successful, JFT therapy may be extended to patients for relief of arthritis in the hip joint.

While beneficial to many, JFT is not the magic bullet for everyone. "Not everyone is going to get the same degree of relief," Atkinson said, "but the majority of people get a benefit from this treatment."

Written by Dawn Hibbard
(810) 762-9865
dhibbard@kettering.edu