Cellular Rejuvenation Gene Therapy Heals Osteoarthritis

[Vmedvil2]

It seems another great victory for Gene Therapy is afoot with the Cellular Rejuvenation of Cells effected by Osteoarthritis, read more at https://medicalxpress.com/news/2019-03-rejuvenation-aging-cells-osteoarthritis-gene.html

Edited March 29, 2019 by VictorMedvil

[fahrquad]

I personally look forward to an effective treatment for Osteoarthritis.  I was in a car wreck back in 1979 and my left thumb that was casually looped around the steering wheel was bent back to touch my forearm on impact.  The windshield post broke and I went face first into the windshield while the post ripped through the top of my left ear.  I came very close to losing my left eye.  Most of the scars have faded over the last 40 years, but the thumb has been getting progressively worse as the CMC joint degenerates.  I was the third car in the accident, and the woman in the second car died shorty after impact, so I can't complain too much.  The drunk in the first car left the 10 month old daughter of the woman in the second car motherless, and he served 6 months in prison.  Needless to say DUI penalties have gotten much more strict.

 

http://www.plasticandhandsurgeon.com/base-of-thumb-pain.html

[fahrquad]

Current treatment options, none of which are acceptable for me.

 

What are the treatment options for base of thumb arthritis?

1. Avoidance of those activities causing pain – easier said than done!
2. Pain killers (analgesics): starting with simple pain killers such as paracetamol and ibuprofen, and later adding in stronger pain killers such as codiene
3. Splinting the thumb – holds the thumb in positions that don’t cause pain 
4. Steroid injection into the CMCJ
5. Denervation of the 1st CMCJ
6. Trapeziectomy (removal of the trapezium bone)  
7. Trapeziectomy with tissue interposition (TI)
8. Trapeziectomy with ligament reconstruction and tissue interposition (LRTI)

Athough it seems quite a drastic step to take, removal of the trapezium bone is the only surgical solution shown to reliably treat base of thumb arthritis in the long term. Partial joint resections and joint replacements have not proven to be successful in treating 1st CMCJ arthritis. 

Studies have found no difference between any of the forms of trapeziectomy. My standard operation is a trapeziectomy and tissue interposition (TI), which means placing some tissue in the space from where the trapezium bone is removed from. The technique I favour uses the joint capsule of the trapezium bone as the “tissue spacer” which would otherwise be left redundant, and does not involve any further cuts on the hand or arm. However if the thumb base is very unstable after removing the trapezium then I will perform a ligament reconstruction combined with a tissue interposition (LRTI) using one of the nearby tendons. 

With increasing frequency I now perform a denervation procedure on the 1st CMCJ. This involves making a similar incision (cut) as with a trapeziectomy, but the trapezium is not removed. Instead the aim is to divide all the nerves to the trapezium, such that no pain is felt from the arthritis. However the results of this operation are variable, and may not completely remove the pain. When successful grip strength is not reduced, and may hopefully even increase, were as with trapeziectomy some loss of grip strength is expected.