Darryl D'Lima, MD, PhD, director of the Shiley Center for Orthopaedic Research and Education (SCORE) at Scripps Clinic, explains how osteoarthritis occurs and affects the knees and other joints. Dr. D'Lima also discussed how research could lead to significant improvements in the treatment of this common degenerative joint condition.
Osteoarthritis happens when the lining of your joint begins to wear out. And then what happens is that you get pain, swelling and sometimes change in the alignment of your knee joint. Usually it's caused by injury or anatomic deformity, but sometimes it happens for no reason.
The common causes of loss of cartilage are either arthritis, in which your cartilage wears out. It could be an injury that could be due to an athletic sport or a traumatic event and a piece of cartilage, or a piece of cartilage and bone get torn off or broken off the knee joint.
We haven't collected all the evidence yet, but we are hopeful that stem cell therapy will actually be able to regenerate cartilage. At the moment, there's some evidence that it reduces the pain due to arthritis. We haven't convinced ourselves that stem cell treatment actually treats the arthritis or cures the arthritis.
The treatments that are on the horizon are stem cell injections. These are injections of stem cells that we can put inside your body, inside a diseased joint, and the premise is that these cells then go in and they counter the disease and sometimes can even restore the lost tissue.
So SCORE does orthopedic research all the way from cell culture and tissue culture, to replacing joints in patients. So under one umbrella, under one Scripps, we can take discoveries from the laboratory through the preclinical stage and all the way up to clinical trials and eventually to the bedside of the patient's care.
The joints that we are treating are the spine, the shoulder, the hip and the knee, but foot and ankle and elbow and wrist are also important joints that we have started doing research into.