Description: Researchers are investigating the use of ultrasound as a treatment of osteoarthritis, which could become the first treatment to actually intervene in arthritic cartilage degeneration.

Start: September 1, 2014
End: August 31, 2016

• Sponsor: U.S. Department of Veteran’s Affairs Health
• Principal Investigator: Neal Bangerter

Project Description:
When it comes to arthritis, many people know that day-to-day living can be a real pain. Arthritis is a general term that refers to joint pain, most commonly occurring in the hands, knees, spine, or hips. The most prevalent form of arthritis today is Osteoarthritis (OA), which describes the wearing away of the cartilage in joints, causing significant friction and pain between rubbing bones. While there are many medications and methods available today to improve symptoms, there is presently no actual method of intervention in the deterioration of cartilage; the best one can do is slow it down and manage pain. This often leads to cortisone shots, physical therapy, and even arthroplasty (total knee replacement surgery).

Dr. Neal Bangerter and graduate student, Merry Taylor, are presently part of a team of researchers seeking treatments to slow cartilage degeneration in patients with knee OA. The research is ultimately being led by Professor Dan Clegg of the University of Utah, and includes Veteran Affairs sites in Salt Lake City, Dallas, and San Diego. They are investigating the use of pulsed low-intensity ultrasound (PLIUS) to administer mechanical stimulation to the knee. Similar stimulation has been shown in preclinical studies to foster production of cartilage at a cellular level. Their work is sponsored by the U.S. Department of Veterans’ Affairs Health, as those who have served in the armed forces are one of the most populous groups diagnosed with this condition.

Intellectual Merit:
The researchers will administer PLIUS using a device currently FDA-approved for healing certain bone fractures. The use of PLIUS is founded on studies that show an increase of chondrocyte production through application of this technology. Integral to the production of certain proteins needed in connective tissue, chondrocytes are the cells that make up cartilage. The researchers will conduct 48-week long trials, including OA patients receiving PLIUS treatment and those receiving sham treatments (similar to a placebo, where the administrator only goes through the motions of administering treatment) in order to compare the two trial groups. After the trial period, the thickness of cartilage in the knee will be measured using MRI technology. The teams from Salt Lake City, Dallas, and San Diego, and BYU will also assess symptoms of pain and joint function in OA patients throughout the study, and evaluate the use of PLIUS as a plausible treatment for knee OA.

Broader Impact:
The results of these trials and subsequent tests could certainly be monumental as a new means of treatment for OA. Since there exists no current method to treat cartilage degeneration, the use of PLIUS would give OA patients the opportunity to work towards actual long-term improvement of the source of their pain through increased cartilage production. PLIUS is easily administered through lightweight and portable devices, and can lead to better daily living, decreased medications, and a more limited number of painful surgeries.