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Orthopedic Researchers Study
Knee Injuries And Degeneration
03
Sept 2007
As
edited by Joint-Pain-Forum.com
The
sort of swelling that occurs when a joint is damaged by injury or
degeneration is normally essential to the healing process, but when it
comes to the knee, that inflammation can actually interfere with
healing.
These findings in experiments with pigs
may lead to treatments for injuries or osteoarthritis in the knee,
according to Duke University Medical Center orthopedic researchers.
There are drugs that can block the action of these immune system
proteins that trigger joint inflammation.
The Duke
researchers report in the September issue of the journal Arthritis
& Rheumatism that two immune system proteins,
interleukin-1 (IL-1) and tumor necrosis factor (TNF), block the healing
of the damaged pig meniscus, an important layer of buffering tissue
within the joint. When agents that counteract the effects of these two
proteins were administered directly to the damaged meniscus, the repair
process resumed.
The primary function of the
meniscus -- a type of cartilage located within the knee joint between
the thigh bone (femur) and the lower leg bone (tibia) -- is to act as a
shock absorber and a distributor of weight within the joint. Nearly 15
percent of all athletic injuries to the knee involve the meniscus, and
the breakdown and loss of this tissue ultimately leads to
osteoarthritis, the so-called "wear-and-tear" form of the disease.
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Article
adapted by
www.Joint-Pain-Forum.com from original press release.
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The researchers, led by Duke
postdoctoral fellow Amy McNulty, Ph.D., said there is a need for a new
approach to treat these injuries. The most common meniscus injury is a
tear. If the tear is small and occurs on the outside of the meniscus,
it can be repaired surgically. However, these repairs don't often work
well. If the tear is large, surgeons often have no choice but to remove
the torn portion, and sometimes the entire meniscus, which leads to
painful movement and ultimately osteoarthritis.
Duke
researchers exposed pig knees to various concentrations of IL-1 and
TNF. They found that as they increased the amounts of the proteins, the
meniscus tissue was less able to repair itself. The range of
concentrations of IL-1 and TNF used in the experiment match those found
in the joint fluid of humans with rheumatoid arthritis and
osteoarthritis, providing further evidence that these proteins could
play a role in the disease process.
According to
Farshid Guilak, Ph.D., senior member of the research team and director
of orthopedic research at Duke, these findings should theoretically
help physicians repair knee joints damaged by injury or osteoarthritis.
"There already is a drug that blocks the effects of
TNF that is used widely and effectively in patients with rheumatoid
arthritis, the form of the disease caused by body's own immune system
attacking the joint," Guilak said. "Another drug also exists that
blocks IL-1 that is being used for rheumatoid arthritis and is
currently undergoing clinical trials for osteoarthritis."
These
drugs are administered to the entire body. However, the key to the
possible new approach would be to deliver these agents directly into
the site of meniscus damage, Guilak said.
The
research was funded by the V.A. Research Service, the National
Institutes of Health and the Arthritis Foundation, which is sponsoring
McNulty's research. Duke's Frank Moutos and J. Brice Weinberg were also
members of the team.
Source: Richard Merritt
Duke
University Medical Center
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