Breaking news on broken-down joints

There’s old news — joint replacements for athletes are downright commonplace, seniors in their 80s and 90s are getting new hips — and now there’s good news. Researchers at the University of California San Francisco, led by sports medicine chief C. Benjamin Ma MD, are finding that damage to the cartilage connecting the foot bone to the ankle bone to the leg bone etc might not have to be permanent.

As almost anyone with a series of sports injuries may know, cartilage damage is permanent. In the words of Dr. Benjamin Ma, chief of sports medicine at UCSF, “cartilage is just lazy” — it doesn’t like to regenerate, so when it gets damaged or worn down through use or injury, it won’t come back on its own.

But Ma and his research team have discovered that given very specific circumstances, cartilage will, in fact, regenerate. The team has been taking knee cartilage from subjects and placing it on a matrix and under some very specific conditions, it is forced to regenerate.

“Cartilage cells are very lazy. They don’t like to grow if they don’t have to,” he said. “So we fool them by doing this particular maneuver and they feel they have to grow, and they form new cartilage. Then we glue it back into the knee.”

The new method has proved to be safe and it helps improve function, and now it is undergoing Phase 3 clinical trials to see whether it in fact works better than microfracture surgeries currently used to treat cartilage injuries.

Down the road, Ma and his team hope to see if there is an application of this method that could help people suffering from arthritis, which is also a cartilage disorder.

That cheer being heard across cyberspace is coming from millions of amateur athletes and the entire population over 50, almost every one of whom could use a little newly invigorated cartilage.

Read more at the San Francisco Examiner.

Cancer, Viruses & Informed Consent

A commentary about cancer screenings and surrounding questions posted yesterday brought a thoughtful reader response: “Science, including public health,” wrote davidlosangeles, “is an evolving process.”  Unquestionably so.

What we the consuming public need to understand is not the science as much as the personal responsibility. Today’s New York Times features another story on the front page of the Business section (some of us still follow old-fashioned newsprint) by Duff Wilson about “Research Uproar at a Cancer Clinic”, namely the highly regarded Carle Foundation Cancer Center in Urbana, IL. It’s another instance of respected professionals questioning each others’ respectability — or protocols, or carefulness, to use gentler terms than are actually being used. One of the issues raised is that of informed consent, and here is where we the consuming public come in. Whether we are cancer patients, CFIDS sufferers or mostly healthy people susceptible to the usual ails, it is incumbent upon the individual to know what he or she is agreeing to, and to know as much as possible about the projected outcome. We’re all in a giant clinical trial here on the planet. Nobody really knows about the outcome, but participation in mini-trials along the way can be valuable and is certainly laudable. Just know what you’re doing.

I am a continuing participant in the Women’s Health Initiative study now well into its second decade, though the primary issues are over and done with. I didn’t try any new hormone replacement therapies or drastic lifestyle changes, mainly because I’m pretty wimpish, but I read every word of the small print in the reams of documents that came along and tried hard to appreciate what the pitfalls and premises were. It was a valuable study, and hopefully will continue to turn up usable data.

Other studies are underway, and more will undoubtedly begin, regarding the current hoopla over XRMV, and H1N1. And heaven only knows how many other viruses, techonological advances, genetic possibilities and scientific wonders are out there to create great harm or great benefit.

Since the benefits are to the buyers, it’s appropriate that the buyer beware.