1. What is osteoarthritis?

Osteoarthritis is a disease in which cartilage, the spongy tissue at the ends of bones in joints, breaks down. Cartilage also acts as a shock absorber. Normally, damaged cartilage is constantly being repaired and where damage repair is not possible, a secondary fibrosis process occurs. As a result of cartilage breakdown, damage to bone occurs. This results in painful, tender, creaky joints with restricted joint movement. Any synovial joint can develop osteoarthritis but knees, hips and small hand joints are the sites most commonly affected.

2. What are the common risk factors of OA?

Common risk factors include:

1. Age: prevalence increases with age

2. Overweight: obesity in women has definitely been shown to be a risk factor for

development of knee osteoarthritis and weight reduction improves symptoms

3. Genetics: some sub-types maybe inherited

4. Hormones: post menopausal lost of estrogen may lead to osteoarthritis

5. Trauma and occupational injuries: especially injuries of the knee joint

6. Vitamin D deficiency: It may predispose patients with established osteoarthritis of the knee to further progression.

3. How is OA treated?

Conventionally osteoarthritis is treated with a combination of pharmacotherapy including Non-steroidal anti-inflammatory drugs, exercise, weight control, surgery, etc. Popular methods include:

1. Analgesics/ Nonsteroidal anti-inflammatory drugs (NSAIDs)/ Topical Pain 2.Relievers/COX-2 inhibitors/Tramadol
3. Physiotherapy
4. Diet/Exercise
5. Weight reduction
6. Visco supplementation
7. Intra-articular injections of steroids etc
8. Surgery (arthroplasty/ joint replacement)

4. How does Stem cell therapy help in OA?

Stem cells are known to be the most efficient human cells, capable of differentiating into different tissue specific cells that are lost due to diseased conditions. Due to technical sophistication, these cells can now be isolated, cultured and exploited for their human clinical applications. Mesenchymal stem cells isolated from the human cord tissue (Wharton’s Jelly) are good candidates in view of their easy availability, immune privileging and strong ability to differentiate into cells of bone, brain and cartilaginous origin. Mesenchymal stem cell (MSC) transplantation along with autologous platelet rich plasma (PRP) has shown promising results for knee OA.

A synergistic effect is seen, if these stem cells are stimulated with patient’s own (autologous) platelet rich plasma before infusion. PRP is a natural source of growth factors. It enhances stem cell proliferation and causes chondrogenic differentiation. Therefore, they can stimulate resident stem cells to enhance their power of regeneration and provide a biological scaffold for formation of new cartilaginous tissue.