Arthritis News and Updates

New treatments and research news

Doctor examining patient's knee
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What is arthritis?

Joint surfaces consist of bone covered with a smooth lining of cartilage. Cartilage is a smooth material that is found throughout your body, and it allows the joint to move freely. When one smooth cartilage surface glides against another, the amount of friction between the surfaces is five times less than the friction of ice gliding on ice!

Individuals who suffer from osteoarthritis, the most common type of arthritis, experience a loss of this cartilage surface.

Also known as degenerative joint disease, or wear-and-tear arthritis, osteoarthritis occurs more frequently in older populations, but can also affect younger individuals.

As the cartilage is worn away, the bone becomes exposed, and the unprotected joint surfaces rub against each other. Patients typically experience symptoms as the joint becomes painful and stiff. Treatment has focused on controlling pain, strengthening the muscles around the joint, and ultimately, joint replacement surgery. However, joint replacement surgery is not optimal, especially for younger patients (under 65 years old). New research has focused on attempting to reverse the arthritic process to restore the normal joint.

Why can't the cartilage heal?

Unfortunately for those who have arthritis, cartilage does not regenerate well in the human body. Unlike a damaged bone, which if protected will heal with new bone, cartilage does not simply heal with time.

Scientists are unsure exactly why cartilage does not tend to heal well, but there are several theories:

  • Cartilage lacks nutrition from blood vessels
    Cartilage does not contain blood vessels, and circulation is a critical part of the normal healing process. The absence of a blood supply may suppress the normal inflammatory response associated with healing.
  • Cartilage exists in an environment that will not allow healing
    Another theory is that synovial fluid, the fluid within joints that bathes the cartilage may be the culprit. The synovial fluid may lack substances needed for healing, or it may contain substances that inhibit healing.

Exactly why cartilage will not heal is not known, and answering this question is the focus of research in reversing the arthritic process.

Is there hope for arthritis treatment?
Several new treatments have been used in attempting to alter the slow degenerative process of arthritis. These treatments have provided some encouraging results, but all have a limited focus and all have only been examined in short-term studies. Whether or not the studies into these treatments show an actual effect or a normal fluctuation in the course of arthritis is difficult to determine.

  • An editorial in the New England Journal of Medicine cautioned "the progression [of] osteoarthritis is sometimes so slow that we delude ourselves into thinking we are doing better than we are." (1)

Excitement over these new treatments has sparked patient interest, and many individuals are understandably willing to try anything.

Joint Supplements

Glucosamine, a common joint supplement, is one of the building blocks of a major component of cartilage, glycosaminoglycans. The theory is that glucosamine, if available in high quantities from supplements, will help to stimulate cartilage growth. Glucosamine supplements are often combined with chondroitin, another of the cartilage building blocks.

  • Pros: Joint supplements can be purchased over the counter at health food stores, and are well-tolerated by patients, without major side effects. There has been one recently completed study in Europe that lasted a period of three years showing patients experienced an improvement in symptoms.
  • Cons: Until this most recent study, most reports studying joint supplements looked at patients for only several weeks, far too short a time period to draw significant conclusions. Many of the studies of glucosamine have been designed poorly and involved a small number of patients. Joint supplements have shown no evidence of reversing the effects of arthritis.


This is an injectable substance made from rooster cartilage cells; it is marketed as a 'motor oil' or lube for the joint. Patients usually receive a series of three to five Synvisc injections. The company that markets Synvisc states that it acts as a lubrication and shock absorber.

  • Pros: Also a well-tolerated medication, Synvisc is easy to deliver into the knee joint through a needle. Relief of symptoms may help delay the need for surgery after Synvisc treatments.
  • Cons: Synvisc has only been approved for use in the knee joint, and studies have shown questionable results. There is no evidence to show Synvisc will reverse any effects of arthritis. A best, patients have pain relief for a period of time.

    Future Treatment

    Exactly what the treatment options for arthritis will be in the future is unclear. New research is focusing on altering the biomechanical properties of cartilage cells. The ideal treatment would be to find a mechanism by which we could reliably stimulate cartilage replacement. Exactly how far away we are from this achievement is not known, but it is certainly a plausible treatment possibility to be used in the future.

     NEJM Vol. 331, No. 14