Cellular Senescence: Management of Healing Biological Processes

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Image Credit: News Medical 

Take care of your mind, your body will thank you. Take care of your body, your mind will thank you. – Debbie Hampton

Article Authors: Gordon Slater| Tandose Sambo 

The human body is a biological marvel that has a multitude of processes that are operating in synchronicity with each other. Cellular senescence is a stress induced condition that results in a variety of age-related health conditions. Medical research has identified that with the appropriate management of cellular senescence, wound healing can be optimised. The catalysts for cellular senescence have been found to be both intrinsic and extrinsic. Biological pathways for the development of senescent cells have begun to be elucidated. Cellular senescence is defined as an essentially irreversible growth arrest that is induced by cellular stresses. These stresses include telomere erosion and DNA damage. Senescent cells are also found to be anti-tumour. 

How is cellular senescence related to stress? 

Cellular senescence is a stress related response that induces mechanisms that are usually attributed to ageing. The first response is a gradual loss of function that occurs in the molecular mechanisms of an organism. While ageing occurs naturally with time, stress can accelerate the process and result in conditions such as atherosclerosis, heart failure, osteoporosis and other conditions. [1]  While various conditions can contribute to the progression of age-related conditions, they are typically naturally identified once persons mature to the 50-60 age range and beyond. 

Impacts of Cellular Senescence 

Cell proliferation and growth is paused by the onset of particular stresses on the body. These stresses include oncogenic stress, and one of the medical theories suggests that senescence is actually a mechanism that evolved as the body’s means of inhibiting cancer growth. If the body can prevent proliferation of malignant cells, it will be possible to sustain the proliferation of healthier cells in the body. Medical science has identified that there are two primary mechanisms by which tumour growth is suppressed. These are via the mechanisms of the proteins p53/p21 and the p16Ink4a/retinoblastoma protein (pRb). These two pairs of proteins have the ability to inhibit malignant tumour growth. This knowledge is phase one of the unfoldment of healing of the body during the more mature phases of life. 

Conclusion

The discovery of cellular senescence is an ever evolving topic that the medical community is now starting to uncover. There are many medical paradoxes that exist, and cellular senescence falls in such a category. While helping both wound healing and tissue repair, the medical community is still attempting to identify how best to optimally utilise the onset of the right senescent cells. The presence of senescent cells is often an indicator of breakdown of normal cellular operation, yet it proves the ability of the body to inhibit adverse conditions.The complexity of cellular mechanisms will take years to uncover, and knowing that the phenomenon exists is of current benefit to medical research. 

As cells become smart enough to know how to proliferate in the body, the maintenance of the right healthy cells can be achieved. Treatment of orthopaedic conditions such as osteoarthritis, could benefit from an understanding of cellular senescence. Knowing the root cause of any condition is the key to preventing its onset, and key to cure. 

Reference: 

[1] Wounds: Cellular Senescence 

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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