ROYAL OAK, Mich. – Researchers at Beaumont Hospital in Royal Oak are studying new ways to treat a painful knee problem and their work is attracting the attention of the Department of Defense.
"Post-traumatic osteoarthritis isn't something that just affects the military, it's not something that just affects athletes, it affects everybody," said Dr. Kevin Baker, director of orthopedic research at Beaumont Hospital in Royal Oak.
Post-traumatic osteoarthritis is arthritis that occurs after an injury. Baker and his team are focused on cases that develop after the rupture of the anterior cruciate ligament, or ACL, a major ligament that stabilizes the knee.
An estimated 200,000 ACL injuries occur each year, often in people under age 30.
"You have two options after an ACL rupture. You can conservatively manage that injury which would mean physical therapy and bracing, or you can opt for surgical reconstruction, which is the more common approach in the United States," Baker said.
Baker said patients who don't have surgery have about a 100 percent chance of developing post-traumatic osteoarthritis in their knee. But even patients who do have their ACL repaired still develop arthritis 50 to 60 percent of the time.
"Patients with post-traumatic osteoarthritis right now will require a joint replacement on average eight years earlier than somebody with primary osteoarthritis or non-trauma-related osteoarthritis," Baker said.
Baker and his team are testing an approach to help slow down or even prevent those problems by modifying the immune system's response to an ACL rupture and encouraging a patient's own stem cells to slow down or eliminate the joint degeneration.
"We give a medication that encourages stem cells to come out of bone marrow and those stem cells, once they come out of bone marrow, they know where to go. They home to the site of the injury," Baker said.
Then they dial down the patient's immune system response. Their method involves tryptophan -- the same tryptophan you hear about in your Thanksgiving turkey.
"By changing tryptophan metabolism inside the joint, we're giving the stem cells that we got there a fighting chance to help protect the joint and preserve the cartilage and hopefully stave off post-traumatic osteoarthritis," Baker said.
It has the potential to save hundreds of millions of dollars in health care costs, not to mention pain and suffering for patients.
The Department of Defense is so impressed by the research so far, that it has awarded the researchers a $1.5 million grant.
Baker explained that post-traumatic osteoarthritis is the leading cause of disability for U.S. service members.
"Out of all the injuries that cause post traumatic osteoarthritis in the knee, ACL injury is the highest in military personnel, and that can occur during battlefield injuries, but that also has a tendency to occur during training," Baker said. "The U.S. military is very interested in ways treat or mitigate or delay the onset in progression of post-traumatic osteoarthritis."
The research is still in the early stages, so researchers don't yet know how long it could take until this potentially becomes something that is available to patients. They hope to have some of those answers in the next couple of years.
"We think that there's a high potential for helping a lot of patients," Baker said.