Impacts of Senescence Signalling 

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.
 

 Senescence Signalling 
Image Credit: Cell Signal Technology

 “Values are related to our emotions, just as we practice physical hygiene to preserve our physical health, we need to observe emotional hygiene to preserve a healthy mind and attitudes.”— Dalai Lama

Article Authors: Gordon Slater| Tandose Sambo

When the root cause of disruption of the cellular growth cycle is influenced by DNA damage, the process is known as cellular senescence. Cellular senescence is an adaptive response in the cellular cycle that is induced by a multitude of influencers within the cell environment. 

As a protective mechanism that keeps an organism healthy, senescence is an inbuilt intelligence that enables healthy cells to keep replicating and enables unhealthy cells to be eliminated by the body. 

The accumulation of persistent senescent cells is directly linked to the prevalence of age related conditions, and inflammatory conditions. 

Mechanism of Action

Human cells have the ability to exhibit replicative senescence. The phenomenon is influenced by the length of the telomeres that are part of chromosomes. The change in length of telomeres initiates a procedure known as DNA damage response (DDR), which short circuits the cell cycle. Cellular senescence can result in additional downstream effects induced by DNA damage. 

Cellular mechanisms take place via a series of intracellular pathways that take place in an organised, systematic manner. Cellular senescence disrupts these mechanisms. According to Cell Signal Technology, the mechanism is outlined below: 

“Similarly, cellular senescence can result in response to DNA damage by irradiation or chemotherapeutics, as well as tumor suppressor loss, elevated reactive oxygen species, and mitochondrial dysfunction. These stimuli signal via a number of intracellular pathways—including the DDR components ATR, ATM, and p53—which converge on the activation of cyclin dependent kinase inhibitors (CDKIs)—p16, p21, and p27—and lead to hyperphosphorlyation of the retinoblastoma protein (RB) and ultimately, withdrawal from the cell cycle.”

Senescent cells have differing physiological shapes to normal, healthy cells. Senescent cells no longer proliferate, and they remain metabolically active. Additional characteristics they possess include:

  1. Showing dramatic changes in their secretome. The secretome is the set of proteins expressed by an organism and secreted into the extracellular space. The process of changing the secretome is known as senescence-associated secretory phenotype (SASP). 
  2. The SASP impacts downstream regulatory processes in the cell cycle
  3. The SASP will have beneficial and detrimental consequences according to the internal cell chemistry. 

Medical science is starting to grasp the factors that cause cellular senescence, and how it impacts human health. With an understanding of the behaviour of cells, the appropriate levers and decisions can be made to optimise health. Treatments such as reversing age-related pathologies, and cancer treatment are the priorities. 

Reference: 

[1] Senescence Signalling: https://www.cellsignal.com/pathways/senescence-signaling-pathway#:~:text=Cellular%20senescence%20is%20an%20adaptive,state%20of%20cell%20cycle%20arrest.

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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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