Joint degeneration (Arthrosis)

What is it?

The most common forms of cartilage degeneration are osteoarthritis (hip, knee, shoulder) and chondral lesions. Osteoarthritis (the most common form of arthritis) is a chronic and progressive disease affecting 10% of people over 60 and is a major cause of pain and disability. It is estimated to become the fourth leading cause of disability by 2025. Osteoarthritis is characterised by cartilage degeneration, inflammation of the synovial membrane (the thin membrane that covers the joint capsule and articular part of the bone) and degenerative changes in the subchondral bone (the bone under the cartilage).  Cartilage, which has the function of cushioning loads and reducing friction between the bones, wears away as a result of advancing age and other predisposing factors (overweight, strenuous work, lack of mobility, autoimmune diseases). This degenerative process leads to limitations in daily and sporting activities.  Early diagnosis is necessary to prescribe appropriate therapy in an attempt to counteract the progression of the disease. This problem does not only affect elderly patients: more and more young people are experiencing early-onset disease, sometimes as a result of repeated trauma or injury, especially in athletes and women. 
Chondral lesions are damage to the cartilage layer lining the joint heads. Chondral lesions can be single or multiple, small and limited or extensive, superficial or deepened into the underlying bone (subchondral bone). Under certain conditions, a movable fragment of cartilage can detach and cause further damage to the joint.

Which are the symptoms?

Increased friction makes the joints less elastic and flexible, resulting in symptoms such as pain, crepitus, swelling, stiff joints and loss of mobility. The symptoms depend on the severity of the damage to the cartilage.

  • pain (arthralgia)
  • swelling
  • ankylosis
  • creaking or squeaking in the joints
  • feeling of warmth
  • functional limitation
  • morning stiffness in the joints

How is it diagnosed?

The main role in the diagnosis of cartilage disease is played by a clinical examination performed by an orthopaedic surgeon, during which the general condition of the joint is assessed. The clinical examination also gives the specialist the opportunity to check the symptoms directly with the patient. The imaging tools commonly used to diagnose these diseases are standard radiographs (traditional radiology remains a fundamental and indispensable method) and magnetic resonance imaging, which has become an increasingly popular method in recent years.

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How is it treated?

The human body is capable of spontaneous healing through normal tissue healing processes involving growth factors and cellular elements with a regenerative function. When these processes do not work, it is possible to resort to advanced technologies that "mimic" physiological healing processes. Regenerative medicine is an interdisciplinary field that combines research and the clinic and uses the therapeutic potential of the body to promote regeneration and restore the physiological condition of tissues affected by disease, injury and aging. Regenerative medicine differs from, for example, transplantation or substitute medicine in that its goal is not to replace what can no longer function in the human body, but to provide the necessary elements to stimulate and support the body's normal healing processes, which, in the case of arthritis, are impaired by the inflammatory state characteristic of the disease. This is made possible using therapeutic agents that are normally already present in the human body, such as platelet-derived growth factors (PRP) and mesenchymal cells derived from bone marrow and adipose tissue (MSC).

RE.GA.IN is a center of excellence that provides a clinical platform to ensure the best possible experience in regenerative medicine. Patients’ data are collected over a long period of time using the most modern standard operative procedure and then interpreted to identify the most performing treatment for a given indication. REGAIN treats the patients only with selected medical devices, paying attention to their scientific quality and safety profile. RE.GA.IN's activities are supported by the Research Laboratories of the Galeazzi Research Hospital to ensure a full characterization of the biological products produced in a custom manner for each patient.

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