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Promoting
better surgical outcomes
What is the problem and
what is already known?
While joint replacement surgery remains one of the most
effective treatments for severe arthritis affecting the hips and knees,
artificial joints can wear down and shed small particles from the
implant into the joint. These particles stimulate the release of
cytokines that contribute to bone loss around the implant. The bone loss
can cause loosening of the implant and require surgery to replace or
revise the implant. This
surgery is painful, costly and often more complicated than the original
surgery. As described in the previous article, a cytokine called RANKL
has been identified as a key player in bone loss in osteoporosis, and
most likely other forms of arthritis. Osteoprotegerin (OPG) has been
found to block the action of RANKL but it is unknown whether use of OPG
is effective in reducing bone loss following a joint implant.
Researchers funded by the
Arthritis Foundation involved in the study: Paul Wooley, PhD & Shang-You Yang,
MD, Wayne State University, Detroit.
Who was studied and what
was done?
This study was done in mice to detect changes in bone following
a technique that simulated a joint implant.
An innovative gene therapy
approach was used to stimulate the production of OPG directly at the
implant site.
What were the study
results?
Administration of the OPG gene therapy effectively reduced
wear-related bone loss in experimental mice.
What’s the relevance to
people with arthritis?
If effective in humans, this type of therapy may help delay or
even prevent the need for revision surgery following a joint implant.
Adds Dr. Wooley: “This approach to controlling bone loss may also be
useful in the treatment of osteoporosis associated with rheumatoid
arthritis. We are currently investigating whether OPG can be beneficial
when combined with a biologic agent such as Enbrel.”
Source: Arthritis
and Rheumatism, September 2002
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12355500&dopt=Abstract
 
Research Update is compiled by
Michele Boutaugh, BSN, MPH, Medical and Scientific Affairs Department,
National Office.
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