Curcumin as a minimally invasive treatment option for modifying post-traumatic osteoarthritis driving processes
OA Version
Citation
Abstract
As the population of individuals with post-traumatic osteoarthritis (PTOA) grows, it becomes increasingly important to expand research into the development of new therapies aimed towards halting disease progression or a cure. PTOA is a progressive disease of the joint that results from joint injury. The disease progresses when the early stages of cell death and inflammation in response to an acute injury are sustained long-term, advancing the irreversible damage of the cartilage and surrounding tissues. It is a debilitating disease that predominantly affects the younger population and is associated with a significant decrease in the quality of life of an individual. Currently, there is no cure for PTOA with disease management aimed towards local symptomatic improvement rather than prevention of end-stage disease.
The newer technologies and treatment drugs that are under investigation for the treatment of PTAO report a significant side effect profile and surgical complications that are not found with nutraceuticals such as curcumin. Curcumin is a naturally derived product of turmeric that has been used in Asia for the treatment of inflammatory disease, cancer, metabolic disorders, and neurological diseases. Animal and in-vitro studies using curcumin as the primary treatment for PTOA have successfully demonstrated the associated benefits of relieving osteoarthritic related pain, inhibiting major inflammatory pathways, suppressing articular damage, and promoting cartilage regeneration. Due to the low bioavailability of curcumin researchers have found it challenging to establish an appropriate treatment regimen via oral or topical applications. Therefore, newer studies have sought to improve the delivery of curcumin with a local approach by using intra- articular injections. Combining curcumin with a microgel formula has proven to be more efficacious in enhancing the disease modifying effects of curcumin on cartilage and the surrounding joint tissues.
The aim of this proposal is to transition the use of intra-articular curcumin microgel injections into human subjects and measure the changes on joint health at a longer interval. Patients will be divided into a control group and treatment group where the treatment group will be subjected to intra-articular injection with curcumin for a total of 2 years. Changes in joint health with be assessed through measurements of range of motion, imaging studies, and pain surveys. I hypothesize that local treatment with intra-articular curcumin injections will delay the progression to end-stage PTOA in the knee joint.
The expected changes include a measurable improvement in range of motion of the joint on mobility testing, a decrease in pain with daily activity as reported by patient survey analysis, and improvement in joint space narrowing on imaging studies. The dual role of curcumin on symptom management and disease modification has greater potential for treating a complex disease such as PTOA. Curcumin is a product that can be made accessible to more individuals suffering from PTOA as it is better tolerated than most current over the counter medications.