Osteoarthritis: The advice of the specialist

Interview with Dr. Hervé Bard, Rheumatologist Specialist at the American Hospital, attached to the Georges Pompidou Hospital (Paris), and Assistant Secretary of the Musculoskeletal Imaging Society. He gives lots of practical advice ...

What are the novelties in the treatment of osteoarthritis?

For the moment, there is no revolutionary novelty! But progress. At the pharmacology level, some slow-acting anti-arthritics have shown a beneficial effect that remains moderate on the symptoms of osteoarthritis of the knee and hip.
They are a good alternative to anti-inflammatory treatments or infiltrations. They are well tolerated, without all the side effects that are known anti-inflammatories or cortisone, but are quite expensive, being little or not supported by the Health Insurance.

There is also hyaluronic acid ...

Hyaluronic acid also provides satisfactory results. Injections of hyaluronic acid into diseased joints can replace or supplement corticosteroid injections. The principle is supplementation of the synovial fluid (viscosupplement), but its delayed and prolonged effects suggest a more complex action on the cartilage. Note that this is a naturally occurring product in the body. To benefit from this treatment, you must contact a specialist doctor.

And for the future?

In my opinion, it is at the level of cellular therapy (chondrocytes, stem cells), and biological with products acting on the molecules involved in the degradation of cartilage, as is already the case in inflammatory rheumatism. The stem cells are taken from the patient himself, at the level of the pelvic bone (the pelvic bone). These stem cells are able to differentiate into different kinds of cells, including cartilage cells. We know how to collect and put them in culture to re-implant them in large numbers to repair a small hole in the cartilage, but not on a large surface.
It is expensive and is still little practiced in France. This treatment is not currently intended to treat an arthritic joint, but it is a way of research ... As the cartilage can not be repaired, once destroyed, it can not be reconstituted, this technique is perhaps to be the means of remaking cartilage. It is, in any case, the most promising technique at the moment.

For bone health, you say that a sufficient supply of vitamin D is essential ...

We do not talk enough. But vitamin D deficiency is the guarantee of bone and muscle problems. However, we have habits of life that prevent us from being sufficiently exposed to the sun. Admittedly, dermatologists are right, we must be careful of the harmful effects of too long exposures. But fleeing the sun that is already rare in our home is taking the risk of vitamin D deficiency. But it is essential for the skeleton and for our health in general. You have to pay attention. And if our living conditions do not allow us enough sun exposure, we must take vitamin D prescribed by his doctor.

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