Among the conditions that are associated with osteoarthritis are the following: Aging, Joint Injury, Joint Misalignment/Dislocation, Repetitive Overuse, Hereditary Factors/Collagen Defects, Obesity, Disease sequela (e.g. Gout, Psoriasis, Sjogren’s Disease, Lupus, Ankylosing Spondylitis, Lyme Disease, Scleroderma, etc), Bone Deformities, Metabolic Diseases (Diabetes, Hemochromatosis).
Medical history, a physical examination, imaging and lab tests help to make an OA diagnosis. Joint aspiration done under local anesthetic may help rule out other causes of similar joint problems. Joint aspiration is a procedure which uses a small needle to remove a sample of joint fluid. This test will look for infection or crystals in the fluid which can rule out other medical conditions or other forms of arthritis. X-rays can show joint or bone damage or changes related to osteoarthritis. Local anesthetic diagnostic injections can also be done to confirm the diagnosis and help with treatment planning. Magnetic resonance imaging (MRI) gives a better view of cartilage and other parts of the joint.
At-home treatments can include: Daily exercise (walking, yoga, aqua classes), Weight Loss, Adequate Sleep, Heat and Cold therapy, Topical Analgesics, Acetominophen. Natural remedies such as fish oil, green tea, ginger, glucosamine/chondroitin sulfate can also be helpful. A high-quality diet may help provide relief from OA symptoms by reducing inflammation and swelling. Eating foods high in the following anti-inflammatory vitamins and nutrients can be highly beneficial such as vitamins C & D, beta-carotene, Omega-3 fatty acids. Increasing your intake of foods with anti-inflammatory properties will help, too. These practices can help take the edge off of your symptoms and improve your quality of life.
Your provider may also be able to prescribe oral or topical pain or anti-inflammatory medications. Hyaluronic acid can be injected into the joint to increase lubrication to temporarily reduce symptoms. Physical Therapy may be prescribed to reduce pain, increase balance, strengthen muscle that surrounds affected joints and to increase range of motion limitations. Splints and braces can also be prescribed to reduce strain to affected joints.
While cartilage is very beneficial to the body, it doesn’t heal itself as well as most other tissues. Cartilage cells (chondrocytes) do not often replicate or repair themselves, which means damaged or injured cartilage will not likely heal well without medical intervention.
Regenerative Medicine procedures are now providing excellent alternatives to help deal with foot and ankle osteoarthritis. The aim of using regenerative medicine is to support your body’s self-healing processes, reverse disease progression and suppress inflammatory reactions that can worsen pain, leading to symptom relief and recovery of function. We utilize Regenerative Medicine procedures including patients’ own Stem Cells to repair the joint naturally. Stem Cells exist in high concentrations in bone marrow which can be aspirated with minimal discomfort, and then injected into the affected area often with concentrated platelet rich plasma. Platelet Rich Plasma has a high concentration of growth factors that activate the stem cells and prompt them to produce additional growth factors and anti-inflammatory cytokines, thereby changing the environment in the joint from inflammatory to healing and regenerating. Platelets (in Platelet Rich Plasma injections) also release growth factors that can increase production of cartilage building blocks (i.e. collagen).
Stem Cells, when injected into the joint may promote angiogenesis which is the increases the blood flow to the affected joint. Stem cells will begin to heal the injury by stimulating cellular proliferation and local repair processes, and by reducing inflammation, resulting in pain relief and improved function.
In many cases, we add Fat Aspirate which acts as a scaffolding and contains different types of regenerative cells. This provides an excellent environment for Stem Cells and helps accelerate tissue repair.
In addition, Alpha-2-Macroglobulin (A2M) can be used to prevent cartilage breakdown in patients, promote tissue growth and support the overall restoration of an affected joint. A2M inhibits the breakdown of cartilage and shuts down the destructive inflammatory proteins in the joint. A2M can prevent and minimize ongoing osteoarthritis.
In very severe cases, surgical options are available to address cartilage degeneration/injury. Among these are: Arthroscopic Debridement, Microfracture surgery, Osteoarticular Transfer System (O.A.T.S) procedure, Arthroplasty (jt removal), Arthrodesis (Joint fusion) or Partial/Total Joint Replacement.
Although Stem Cell Therapy is considered by some people to be experimental, various research studies show that regenerative stem cell therapy and platelet rich plasma injections can provide excellent relief from joint and musculoskeletal pain and ongoing inflammation