SCIENTISTS have found a solution that could reduce the risk of osteoarthritis developing in tens of thousands of people who undergo orthopaedic surgery every year - sugar.
Patients who have surgery for joint problems are at increased risk of developing osteoarthritis because the operation itself can damage cartilage cells.
But a team at Edinburgh University have found simply adding sugar to the saline solution used to wash out joints during procedures protects cartilage from being damaged and may even help it to repair.
Osteoarthritis, which affects more than eight million people in the UK, occurs when cartilage at the ends of bones wears away, leading to stiff, painful joints. There is no cure and treatment is limited to pain relief and joint replacement in severe cases. In Scotland officials estimate that up to 95,000 patients see a GP or practice nurse about the problem in a year. Most sufferers are over the age of 65.
The main risk factors for developing for the condition are ageing, obesity, and joint damage. People who undergo surgery or investigative procedures to diagnose joint problems - often because of a sports injury or unexplained joint pain - are at an increased risk of developing osteoarthritis because surgery can damage the joint and surrounding tissue by destroying cartilage cells called chondrocytes.
Dr Andrew Hall, principal investigator for the study which was conducted at Edinburgh University's Centre for Integrative Physiology, said: "The surgeons are extremely skillful but you have very little space inside the joint. The probe can gouge and cut. In all the different procedures where mechanical force is being applied this sugar solution seems to give some protection."
For the research Dr Hall's team at Edinburgh University conducted operations on rats using both the traditional saline and enhanced sugar solutions. When they later examined the rats they found a significant difference. Dr Hall said: "You could still see the injury but in the ones that had been treated with sugar solution you could see the cartilage was trying to repair the damage."
It is understood that sugar raises the osmotic pressure of the saline, which protects the cells against injury during surgery.
The researchers, whose work was funded by Arthritis Research UK and published in the journal Osteoarthritis and Cartilage, describe the solution as 'chondroprotective' because it protects the cartilage cells against injury.
Dr Hall said: "Our findings could have major implications for tens of thousands of people who undergo arthroscopic surgery, such as footballers or other sportspeople who've damaged their cartilage. Or in fact anyone who's had exploratory surgery for a sore or painful knee.
"There is a worry that all these people are at risk of developing osteoarthritis from their surgery. But if surgeons can be persuaded to use this chondroprotective solution as standard that risk could be substantially reduced. It's a cheap, simple solution that can protect the cartilage in the joint during arthroscopy and surgery."
He explained the sugar solution was more like the fluid which is naturally present in joints and said there was no evidence of negative side effects from using it during his research.
Dr Stephen Simpson, director of research at Arthritis Research UK, said: "It's extraordinary that something as simple as a sugar solution can have such a beneficial, protective effect on the joints during surgery and can actually help repair cartilage damage.
"It seems a simple yet potentially valuable step that surgeons around the country could be persuaded to include in their procedures."
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