Comparative Medicine On Osteoarthritis

For human and veterinary patients alike, osteoarthritis is the most common form of arthritis afflicting joints1. Research into the disease pathogenesis and therapies is currently ongoing in both medical fields. While there is no clinical cure, treatments ranging from stem cell therapy to holistic medicine options have become available for patients. The similar nature of this disease in both human and veterinary patients renders itself to allowing for opportunities in translational medicine. The current understanding of the pathogenesis of osteoarthritis involves the degeneration of cartilage in a synovial joint capsule, abnormal bone growth, osteophyte formation, and an immune-inflammatory response.

It is thought that many processes may initiate an inflammatory response in the joint. When this develops, chondrocytes lose the ability to form new cartilage, and abnormal bone remodeling occurs. Rather than a smooth surface between two articulating bones, the surfaces become fraught with osteophytes and subchondral cysts2.

In contrast to their human counterparts, veterinary medicine patients typically have osteoarthritis caused by developmental problems.

The underlying congenital disease could be antebrachial growth deformities causing elbow dysplasia, patellar luxation, cranial cruciate ligament disease, hip dysplasia, or osteochondritis dissecans4. Often due to its congenital nature, the presentation of the disease is common in younger animals. Even though there is a difference in the patient’s age demographics upon presentation, there seem to be similar clinical signs attributed to this disease between the two medical fields. Human and veterinary patients will exhibit signs of joint stiffness (especially getting up from a seated/resting position), lameness, pain, exercise intolerance, and a reduced range of movement5 1.

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It is important to assess the history of the patient and complete a thorough orthopedic exam when diagnosing a potential osteoarthritis case. The primary way to diagnose osteoarthritis is through radiographs, although this diagnostic test is not without its limitations. Osteoarthritis can be radiographically characterized by osteophyte formation, decrease in articular cartilage, joint space narrowing, and inflammation. The disease pathogenesis must be well developed for evidence of osteoarthritis to be seen on radiographs. Pre-clinical or soft-tissue changes may not produce radiographic findings1. Additional forms of testing include synovial fluid analysis, arthroscopy, or advanced imaging3.

Due to the complexity of the disease, multimodal management is considered the best approach in both veterinary and human medicine. Veterinary patients more commonly experience secondary osteoarthritis. Given the developmental problems, surgical intervention of the primary issue is often considered in veterinary medicine to help prevent or mitigate the effects of osteoarthritis4. Examples of surgeries treatments include tibial plateau leveling osteotomy or a femoral head ostectomy (arthritis management and prevention)6.

Rather than target the underlying condition, most human treatments attempt to alleviate the clinical symptoms or to prevent the occurence1. The use of pharmaceuticals, including opioids and non-steroidal anti-inflammatory are efficient at managing pain, but do not reverse or help to prevent cartilage damage. Therapeutic interventions such as these are also used in veterinary medicine as well. Additionally, weight management/reduction via diet have shown to reduce clinical signs of osteoarthritis in both types of patients3 7. In both fields, total joint replacement surgery, stem-cell therapy, arthroscopic debridement, and microfracture drilling surgeries are considered for severe cases of osteoarthritis8 3 .

Osteoarthritis is a disease that impacts individuals across species. For this reason, osteoarthritis research using animal models has been essential in formulating our current understanding of the disease. Disease processes and treatments are studied in large animals, while pathogenesis and etiology is commonly studied in the small animals1. With each osteoarthritic model used, this disease is better understood, which benefits both veterinary and human patients. There is a difference in several aspects of the presentation and management of osteoarthritis among the veterinary species and humans, but the translational relevance of current research is tremendous.