Restoration of the osteoarthrotic joint.

Abstract

Even the most effective current treatments for osteoarthrosis do not restore the joint2,4. Non-operative treatments, including modifications of lifestyle, exercise programs, medications, and physical therapy, can decrease symptoms and improve mobility, but they do not detectably alter the course of the disease for most patients4. Arthrodesis of degenerated joints relieves pain but sacrifices mobility. Osteotomies of the hip and knee can decrease pain and, in some patients, can lead to formation of a new articular surface2,10, but the results vary considerably among patients. Resection of degenerated joints and replacement of these joints with implants fabricated from polyethylene, metal, or another synthetic material predictably relieves pain and improves function. However, these procedures have important limitations, especially for young, active patients, primarily because they do not restore an articular surface with the mechanical properties and durability of articular cartilage. Moreover, synthetic materials must be fixed to the bone of the patient. Thus, the wear of the implant surfaces limits the life span of the implant. Within this life span, the bond between the implant and the bone may fail. For all of these reasons, treatments that restore …