Thursday, January 07, 2016

Pre-arthritis- A new entity in joint damage.

Every body has heard about osteo-arthritis and early osteo-arthritis. I intend to present a newly coined term known as " Pre-arthritis".
Let us first understand the existing terms. 
1) Osteo-arthritis- This is the end stage of the disease and represents a joint failure. In symptomatic patients, this requires joint replacement. It is visible on plain x ray itself and doesn't need further investigations. 
2) Early Osteo-arthritis- In this condition structural damage has set in but is not yet visible on plain x rays. It may be seen on MRI scans or arthroscopy. Its course is yet unclear. Cartilage lesions may be asymptomatic. Left to its own course, it may lead to osteo-arthritis after a decade or two. This stage can be suspected in young people. Interventions like cartilage repair are available which can halt the progression of the condition to full fledged osteo-arthritis. 
3) Pre- arthritis- Finally we come to this new condition and we can only understand in the context of the above two conditions. A bunch of cartilage specialists got together last year and coined this term. There is no structural damage to be seen yet. However at a micro level, molecular changes have set in and will lead to early arthritis. It is suspected after a joint injury or a menisectomy. Joint aspiration and micro environment studies can pick up elevated levels of harmful chemicals called 'cytokines".
It can also be diagnosed by probing cartilage during an arthroscopy or an MRI showing bone marrow edema.
The benefit is that sports persons with the above two conditions can come under the supervision of a cartilage specialist and get an early intervention as and when structural damage sets  in. 
The good news is that a PRP or stem cell injection can avert further progression. Visit and to remain abreast of stories and latest developments in the field of cartilage injury and joint preservation. 

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