The recent events in the orthopedic field and knee surgeries are the subjects we discuss in this article.

The recent events in the orthopedic field and knee surgeries are the subjects we discuss in this article.

The New Method for Stopping the Osteoarthritis Effects

Although there is no cure for Osteoarthritis, a group of researchers has found a new method to stop the disease's effects through a simple knee injection.

The findings of their research were published in Science Translational Medicine. These researchers have found a protein pathway in mice and put this target pathway into overdrive and halt cartilage degeneration over time. They showed that this method could dramatically decrease knee pain and cartilage degeneration.

Ling Qin is an associate professor of Orthopedic Surgery who studies epidermal growth factor receptor (EGFR). He describes the results of his experiments progress for treating Osteoarthritis for the first time.

After the result of their experiments were approved, they turned an eye to the clinical treatment solutions.

"Free EGFR ligands have a short half-life and cannot be retained inside of a joint capsule due to their small size," explained Zhiliang Cheng, Ph.D., a research associate professor in Penn Engineering and another of the co-corresponding authors on the paper. "Nanoparticles help to protect them from degradation, restrict them within the joint, reduce off-target toxicity, and carry them deep inside dense cartilage to reach chondrocytes."

"While many of the technical aspects of this application still need to be worked out, the ability to stop or slow the course of osteoarthritis with an injection rather than surgery would dramatically change how we feel and function as we age and after injury," said one of the study's co-authors, Jaime Ahn, a former faculty member at Penn Medicine now chief of orthopedic trauma and associate chair of orthopedic surgery at the University of Michigan.

Qin's team is hopeful of designing a drug and test in large animals to prove their drug's efficiency and help more than 27 million osteoarthritis patients in the U.S.

AI helps Patients with Osteoarthritis of the Knee

Artificial Intelligence is the latest technology that helps patients with Osteoarthritis who think about total knee replacement. Various ways exist to treat knee OA. So, these choices have made the field ready for shared decision-making and growing patient-reported outcome measures.

After experimenting on 129 adult patients with Osteoarthritis knee pain, they included collaborative decision-making, patient satisfaction with consultation, KOOS JR score, consultation time, TKR rate, and treatment concordance, the secondary outcomes, and the decision quality as the primary outcome.

"The findings of this study suggest that multifaceted decision aids integrating patient education, preference assessment, and AI-enabled analytics built with PROM data can provide a personalized, data-driven approach to SDM for patients with advanced knee OA considering TKR" the researchers wrote in their conclusion. "The patient-centered, data-driven approach to SDM in this study may mark a step-change in the application of patient decision aids in orthopedic practice."


Bone Cancer Treatment with the Combination of Two Drugs

Bone cancer or Osteosarcoma is the most well-known cancer among children and adults. Methotrexate is a long-used chemotherapy drug often used to cure bone cancer. After the researchers studied the human cells and mice, a two-drug combination would be effective and less toxic methotrexate. 

"We are interested in developing therapies that kill cancer cells without harming healthy cells, potentially avoiding the sometimes-severe side effects of traditional chemotherapy." Said Brian Van Tine, MD, Ph.D., Study Senior Author and Associate Professor of Medicine, Washington University. "In high doses, methotrexate can lead to liver failure and the need for kidney dialysis. We want to get rid of the methotrexate in this regimen and replace it with a targeted metabolic therapy that would shorten the treatment, reduce the side effects and potentially eliminate the need for multiple hospitalizations."

The scientists studied a drug called NCT-503 and then added a second drug which blocks mTorc1 to make the bone starved of energy and die.

"When we added a mTORC1 inhibitor, suddenly we could control tumor growth in mice for a prolonged period, well past when the cells would adapt to treatment with either drug alone," said first author Richa Rathore, Ph.D., who just completed her doctoral studies in Van Tine's lab "We are still working to optimize these drug treatments, but we hope to be able to take these findings into a clinical trial," Van Tine said.

"In the future, we would like to add more metabolic therapies so that one day we might be able to eliminate the remaining chemotherapy drugs that these patients will still receive. The ultimate goal is to transform therapy by going after the metabolic properties inherent to Osteosarcoma and moving away from the classic drugs that damage the whole body."

The First Response to Predict Patient Satisfaction with Contralateral Knee Replacement

According to a study published in Knee Surgery, Sports Traumatology, Arthroscopy, the patients' first response with OA of the knee was achieved in the radiographic Osteoarthritis in that knee.

"The purpose of this study was to determine whether predictive factors can be found to prognosticate the outcome of the second-side knee replacement when a patient has an unsatisfactory response to the first, with the hypothesis that predictors, such as prosthetic factors and radiographic level of OA, may be able to predict a satisfactory response to the contralateral knee replacement," the researchers noted.

They concluded that in the patients who had not a satisfactory response with the first knee replacement, radiographic OA was the core predictor of their contralateral knee replacement's satisfaction rate.