อัพเดตเมื่อ: ก.พ. 10
WHAT IS OSTEOARTHRITIS?
Osteoarthritis is a condition in which the cartilage (natural cushioning between joints) wears off. When this occurs, the bony part component of the joint rubbing more and more against each other as a consequence of decreasing cartilage, the shock-absorbing part. This rubbing creates in pain, stiffness, swelling, reduce the ability to move, and also sometimes the formation of bony projection along the bone edges. 
SYMPTOMS •Loss of flexibility. You may not be able to mobilize your joint throughout its full range of motion. •Grating sensation. You may feel a grating sensation when you exert the joint, and you may hear crackling or popping. •Abnormal bone growth. Bone spurs are the extra bits of bone, which perceive like hard mass, can form surround the affected joint. •Swelling. This caused by the inflammation of soft tissue around the joint. •Pain. Affected joints may painful after or during movement. •Stiffness. Joint stiffness may be most detectable upon awakening or after being immobile for a long period. •Tenderness. Your joint may feel painful when you press a light pressure to or near the joint.
WHAT CAUSE OA KNEE?
Osteoarthritis has a multiple constituent etiology, which come from the influence of local and systemic factors. Osteoarthritis happens in all ages. The theory of this disease, in which particular responsible genes are related to its incident. Obesity, sports participation, genetic susceptibility, and injury to the joint, predispose young athletes to the progress of premature osteoarthritis. History of knee trauma multiplies the risk of knee osteoarthritis 3.86 times. Female gender, Old age, obesity and overweight, knee injury, bone density, repetitive use of joints, joint laxity, and muscle weakness, all play roles in the development of joint osteoarthritis 
RISK FACTORS OF KNEE OSTEOARTHRITIS •Age •Trauma •Muscle weakness •Joint laxity •Mechanical forces •Repetitive knee trauma •Kneeling Squatting •Meniscal injuries •Genetic susceptibility •Obesity •Female gender
OSTEOARTHRITIS KNEE, HOW TO PREVENT?
A number of risk factors might put a person at risk of developing osteoarthritis. Making changes may not reverse the condition, but a person may be able to decrease their risk or keep osteoarthritis from progressing. •Keep your healthful weight: Excess weight puts more pressure on the knees. Over time, this gives to wearing down the cartilage. Excess fat can also induce the body to secrete cytokines, a type of protein. This can lead to extensive inflammation, and it can turn the way that cartilage cells work. •Managing blood sugar: High blood sugar levels can influence the structure and function of cartilage, and diabetes enhances the risk of cartilage loss and inflammation. •Regular exercise: Moderate intense exercise can keep the joints stay flexible, strengthen the muscles that hold up the knees, and decrease the risk of various health problems. It may help to walk, gardener, swim for 30 minutes at a time, five times per week.
Everybody who has not exercised for a long period, possibly due to hard with mobility, should ask a medical professional for recommendations about how to start. •Reducing the injury risk: Cartilage that persisting damage from a repetitive injury is more prone to develop osteoarthritis later. It would be better to decrease the risk of slipping in the house by wearing shoes that fit well and use protecting equipment while playing sports to save injury. •Keep away from overuse: Some sports or professions related to repetitive movement of the knee joint, such as squatting or kneeling. People who usually lift more than 25kg might have an increased risk of osteoarthritis. Jobs that set people at risk such as unloading trucks or ships and laying carpets. Varying activities and getting adequate rest interval of work or exercise might help.  OA KNEE TREATMENT OPTIONS. Osteoarthritis is a degenerative and progressive problem, with the damaged structure is unlikely to revert and repair. So, current treatment modalities are targeted towards symptom management until the degree of severity dictates the necessity of surgical treatment with joint replacement.  •Rehabilitation: There are different treatment options for osteoarthritis, for example occupational, physical, and alternative therapies. o Physical therapy uses exercises to strengthen muscles and enhance flexibility and joint mobility. o Occupational therapy targets helping you better cope with your normal activities and lifestyle, for example, get the dressing, walking, and bathing. You may only need these treatments for a short period as you learn to manage with your osteoarthritis or as your symptoms exacerbate.
o Alternative treatments for osteoarthritis can include massage, relaxation therapies, and hydrotherapy. Acupuncture may also be useful. That acupuncture may be effective in decreasing osteoarthritis symptoms when used with additional medicines, or, in some scenarios, in place of pain medication together. o Medication: Many patients with osteoarthritis take medications to reduce pain and symptoms, such as: o Acetaminophen This is frequently the first-line treatment for those with mild-to-moderate osteoarthritis pain. Common side effects such as upper stomach pain and nausea. o Nonsteroidal anti-inflammatory drugs (NSAIDs). If acetaminophen can’t provide relief, you may consider a Nonsteroidal anti-inflammatory drug for example ibuprofen or naproxen. These over the counter medicines can sometimes generate stomach problems.  o Supplement with hyaluronic acid: Hyaluronic acid (HA), is natural glycosaminoglycan produce by intra-articular cells that synthesize joint lubrication fluid. It provides viscous lubrication, has shocking absorbing features, and additionally, possible anti-oxidant and anti-inflammatory functions have been reported. The current proof regarding effectiveness is conflicting o Intra-articular injection treatment choices for knee osteoarthritis: o steroid injections: steroids, can suppress the immune response and interrupting the inflammatory cascade at multiple levels. It is believed that these are some of the processes of increase joint mobility and pain relief in knee osteoarthritis.  o Intra-articular hyaluronic acid for the knee: Tend to be less beneficial than those for steroid injections. The 2013 American Academy of Orthopedic Surgeon guidelines strongly recommends against the use of hyaluronic acid for the symptomatic knee.
CELLULAR THERAPY FOR OSTEOARTHRITIS OF THE KNEE PLACENTA EXTRACT
The human placental extract has been used for decades in Japan and China as a treatment agent for liver endocrine abnormalities and regeneration. Placenta extract has been proved to have wound-healing, anti-inflammatory, and antioxidant effects in the clinical trial . Placenta Extract enhances natural healing through nervous regulation, hormonal regulation, and immune- regulation, giving the body resistance toward disease. Placenta Extract carries a variety of nutrients growth factors and anti-oxidant. (You can see more detail placenta extract component follow this link https:// www.ivtherapybangkok.com/placenta-extract-bangkok) Osteoarthritis is an inflammation which rises because of degeneration (deformation) of the joints. When bones aging this cartilage can be punctured or wear out, and the pain of two bones directly rubbing against each other is the symptoms of osteoarthritis. The condition can go undetectable or if it isn’t very severe, often with bouts of sudden pain. Placenta extract can be used to successfully treat osteoarthritis. While the placenta’s Anti-inflammatory Function can work against the pain, its Tissue Repair ability promotes regenerate of the damaged tissues. Another feature of attack is its “Insulin-Like Growth Factor” which enhances the growth of smooth muscle cells and cartilage and is remarkably efficient at treating and preventing osteoarthritis. Professor Kazuhito Asano and his team at Showa University’s Medicine Department described that high levels of active oxygen were observed in the joints of sufferers of osteoarthritis and rheumatoid arthritis, this is likely to be a cause of symptom degeneration and pain. Asano’s group found active oxygen in the joints of 40 osteoarthritis patients and 19 rheumatoid arthritis patients who visited their university hospital and detected no active oxygen in the joints of healthy people. The severity of the symptoms of each patient was graded into four levels, and those with the most severe clinical had on average 2.5 times in the case of osteoarthritis patients and five times the levels of active oxygen in the case of rheumatoid arthritis patients and, compared to those with the least severe symptoms. They concluded that active oxygen was damaging the tissues in the joints and causing the condition to degenerate. As the placenta has an Active Oxygen eliminate Function it can play this additional beneficial role in rheumatoid arthritis and osteoarthritis treatment. 
STEM CELL THERAPY
Stem cell treatment for knees is minimally invasive. It’s a way that can decrease inflammation, repair, and slow all these types of damage from joint inflammation, and prevent or delay knee replacement surgery. In the study, only one knee was injected. Although the natural deterioration of the knee continues, at five years, those knees that are injected with stem cells are in better shape than they were before the injections.
STEM CELLS TREATMENT FOR KNEE
MECHANISM OF ACTION
Researchers believe that stem cell therapy for the knee works by: •Developing into essential cartilage cells •Produce proteins called cytokines that slow degeneration of cartilage and reduce pain  •Prevent the inflammation that can worsen arthritis
STEM CELLS THERAPY FOR KNEE, EFFECTIVITY.
Recently, a group of researchers from the Krembil Research Institute, University Health Network in Toronto, Canada focused on the beneficial use of stem cells to treat knee osteoarthritis. They reported their results in the journal STEM CELLS Translational Medicine. The researchers wanted to know whether it may be possible to regenerate and repair knee cartilage using mesenchymal stromal cells (MSCs). These cells can develop into a number of various cell types, including bone, muscle, and importantly, cartilage. In all, the researchers recruited 12 patients with moderate-to-severe knee osteoarthritis and extracted mesenchymal stem cells from each person's bone marrow. In this pilot study, one of the main aims was to understand what establishes a safe and viable dosage, so the researchers injected each patient with one of three different doses of MSCs. 12 months after treatment, the researcher followed the patient, assessing their progress. For instance, they measured the inflammatory biomarkers level and the cartilage breakdown rate, and they check regular MRI scans of the affected joints. They also asked the participants to rate how well they felt they were doing. By the end of the year-long study, the researcher found that there was a significant decrease in pain and an increase in quality of life. There was a significant decrease in inflammation within the knee joints of the patients, which is crucial because experts now believe inflammation to be an important key driver of osteoarthritis. 
STEM CELL TREATMENT FOR KNEE SIDE EFFECTS
Stem cell therapy for knees is noninvasive and infrequently painful. Side effects are minimal. The most common experiences after the procedure such as mild pain at the injection site, swelling. 
Reference 1.WEBMD, Osteoarthritis, Reference “Osteoarthritis of the Knee (Degenerative Arthritis of the Knee)” https://www.webmd.com/osteoarthritis/ostearthritis-of-the-knee- degenerative-arthritis-of-the-knee#1 2.Mayo clinic , Osteoarthritis https://www.mayoclinic.org/diseases-conditions/ osteoarthritis/symptoms-causes/syc-20351925 3.Behzad Heidari (MD), Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I 4.Medically reviewed by Gregory Minnis, DPT on August 15, 2018 — Written by Brian Wu, Medicalnewstoday.com “The stages of osteoarthritis of the knee” 5.Juan C Mora, Knee osteoarthritis: pathophysiology and current treatment modalities , Journal of Pain Research 2018:11 2189–2196 6.Keck School of Medicine of USC, Department of Orthopaedic Surgery, Los Angeles, CA, USA” Intra-articular treatment options for knee osteoarthritis”, Nat Rev Rheumatol. Author manuscript; available in PMC 2019 August 01 7.Healthline, Medically reviewed by William A. Morrison, MD on January 3, 2017 — Written by Chaunie Brusie, RN, BSN, “Treatment for OA knee, what’s work ? “ 8.Medically reviewed by William Morrison, MD on August 21, 2018 — Written by Jennifer Leavitt, MS. “Can stem cell therapy repair the damage knee” Healthline 9.Written by Tim Newman on April 23, 2019 - Fact checked by Isabel Godfrey, MedicalNewsToday, “ Using Stem Cells to combat osteoarthritis 10.Kentaro Yoshida, Placenta Power: For Health and Beauty A useful guide for those seeking placenta-based remedies