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Arthritis

The Alarming Impact of Routine X-Rays on Arthritis Patients’ Decisions

Knee osteoarthritis is a major cause of pain and disability, but routine X-rays often do more harm than good. New research shows that being shown an X-ray can increase anxiety, make people fear exercise, and lead them to believe surgery is the only option, even when less invasive treatments could help. By focusing on clinical diagnosis instead, patients may avoid unnecessary scans, reduce health costs, and make better choices about their care.

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The Alarming Impact of Routine X-Rays on Arthritis Patients’ Decisions

Osteoarthritis is a leading cause of chronic pain and disability, affecting millions worldwide. While routine x-rays are not recommended for diagnosing knee osteoarthritis, nearly half of new patients visiting a general practitioner in Australia are referred for imaging. This unnecessary use of x-rays not only wastes the health system A$104.7 million each year but also affects how people think about their knee pain and may prompt them to consider potentially unnecessary knee replacement surgery.

Our study reveals that using x-rays to diagnose knee osteoarthritis can lead patients to believe they need knee replacement surgery more than those who receive a clinical diagnosis without x-ray images. In fact, people who received an x-ray-based diagnosis were 36% more likely to think they needed surgery compared to those with a clinical diagnosis.

But what happens when you get osteoarthritis? It arises from joint changes and the joint working hard to repair itself, affecting the entire joint, including bones, cartilage, ligaments, and muscles. Many people experience persistent pain and difficulties with everyday activities like walking and climbing stairs.

While knee replacement surgery is often viewed as inevitable for osteoarthritis, it should only be considered for those with severe symptoms who have already tried appropriate non-surgical treatments. Surgery carries risks of serious adverse events, such as blood clot or infection, and not everyone makes a full recovery.

Most people with knee osteoarthritis can manage it effectively with:

1. Pain relief medication
2. Exercise and physical activity
3. Weight management
4. Assistive devices

Debunking a common misconception, research shows that the extent of structural changes seen in a joint on an x-ray does not reflect the level of pain or disability a person experiences. Some people with minimal joint changes have very bad symptoms, while others with more joint changes have only mild symptoms.

In our study, we found that people who received an x-ray-based diagnosis and were shown their x-ray images had a higher perceived need for knee replacement surgery than those who received a clinical diagnosis without x-ray. They also believed exercise and physical activity could be more harmful to their joint, were more worried about their condition worsening, and were more fearful of movement.

What does this mean for people with osteoarthritis? Our findings show why it’s essential to avoid unnecessary x-rays when diagnosing knee osteoarthritis. By reducing unnecessary x-rays, we can ease patient anxiety, prevent unnecessary concern about joint damage, and reduce demand for costly and potentially unnecessary joint replacement surgery.
In conclusion, while changing clinical practice can be challenging, reducing unnecessary x-rays could help improve patient outcomes and reduce healthcare costs.

So, if you have knee osteoarthritis, know that routine x-rays aren’t needed for diagnosis or to determine the best treatment for you. Getting an x-ray can make you more concerned and more open to surgery. But there are a range of non-surgical options that could reduce pain, improve mobility, and are less invasive.

Arthritis

Breaking New Ground in PTOA Treatment: A Self-Healing Hydrogel to Revolutionize Joint Care

Post-traumatic osteoarthritis (PTOA) is a condition that affects joints after an injury. Current treatments focus on relieving symptoms but do not prevent or stop the progression of the condition. Although emerging therapies have shown promise in preclinical studies, a major obstacle is delivering these therapies effectively into the joint, a highly dynamic environment subjected to constant mechanical stress. Researchers have created a new hydrogel to improve drug delivery for treating PTOA.

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Breaking New Ground in PTOA Treatment: A Self-Healing Hydrogel to Revolutionize Joint Care

Post-traumatic osteoarthritis (PTOA) is a condition that affects joints after an injury, causing chronic pain and limiting mobility. Current treatments focus on relieving symptoms but do not prevent or stop the progression of the condition. However, emerging therapies have shown promise in preclinical studies, and now researchers at Mass General Brigham have created a new hydrogel to improve drug delivery for treating PTOA.

This innovative hydrogel is designed to offer sustained drug release even during continuous joint movement, which is crucial for physically active patients who need effective treatments that allow them to maintain their lifestyles. The self-healing properties of the hydrogel ensure long-lasting, stable, and sustained release of disease-modifying drugs, significantly reducing cartilage damage and improving joint lubrication.

The researchers used triglycerol monostearate (TG-18), a common food additive, to create this revolutionary hydrogel that rapidly repairs itself after mechanical stress. In a mouse model, they found that the hydrogel was self-healing, meaning it liquefied under mechanical stress and then instantly reformed. This property ensured that the disease-modifying drug was released consistently, even during continuous joint movement.

The potential impact of this breakthrough is immense. As co-senior author Joerg Ermann, MD, an attending rheumatologist at Brigham and Women’s Hospital, explained, “Our hydrogel technology could transform the treatment of PTOA by reducing the need for frequent injections, slowing disease progression, and potentially delaying or preventing surgery.” This is particularly important for athletes, military personnel, and young adults recovering from joint injuries who need effective therapies that allow them to maintain active lifestyles.

The results of this study are published in Proceedings of the National Academy of Sciences, and the researchers are optimistic about the future of PTOA treatment. As lead author Nitin Joshi, PhD, associate bioengineer at Brigham and Women’s Hospital, noted, “We recognized these limitations and designed a hydrogel that continuously releases medication without being affected by mechanical stress.” This innovative approach has the potential to revolutionize joint care and improve the lives of millions of people worldwide.

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