What is Osteoarthritis?

Osteoarthritis is a condition that results in the loss of articular cartilage from the knee. This is the smooth lining of the joint and it’s loss causes pain and difficulty performing weight bearing activities. Osteoarthritis is a progressive condition with loss and damage of the articular cartilage occurring over many years, the end result of which may be complete loss of cartilage leaving bare bone and patients often requiring knee replacement surgery.

Osteoarthritis has traditionally been thought of as simply ‘wear and tear’. However recent scientific advances have led to an increased understanding of osteoarthritis. We now believe that osteoarthritis is driven by an inflammatory pathway.  In the healthy knee there is a balance between anti-inflammatory (‘good’) proteins called cytokines  and pro-inflammatory (‘bad’) cytokines. The anti-inflammatory cytokines block the action of the pro-inflammatory cytokines and prevent the activation of enzymes that cause damage to the articular cartilage. 

In the osteoarthritic knee there is an imbalance between the anti-inflammatory and pro-inflammatory cytokines. There is an excess of pro-inflammatory cytokines which results in the activation of a number of enzymes which start to degrade the articular cartilage. This worsens the inflammatory environment and accelerates damage to the articular cartilage leading to progressive loss.

The increased understanding of the science of osteoarthritis has led to the development of orthobiological treatments which aim to change the biological processes driving osteoarthritis.  There are a number of orthobiological treatments available. The Early Intervention Knee Clinic believes that AAI (autologous anti-inflammatory injection or ‘nSTRIDE’) offers the most robust scientific basis and best clinical results.