Does anyone know of a way to regenerate the hip joint once it is bone on bone.

Hello Dean,

I think what you might be asking is if there is way to regenerate new cartilage. For a hip that is showing bone on bone or just as my arthritic shoulder joint is bone on bone, both conditions are having either deterioration of cartilage or complete loss of cartilage. When the cartilage "cushion" has deteriorated, the pressure of bone on bone can cause pain along with bone spurs putting pressure on surrounding tissue and nerves.  

As far as I know, there is not yet any method whereby cartilage cells are regenerated for any joint, even though i see advertisements for so-called stem cell injections which cannot create anything because the material being injected is comprised of dead amniotic stem cells or sometimes even bone marrow stems. Either way, the cells in the injections are not living. Some companies make the claim that these injections stimulate growth factors, but again they never say exactly what the growth factors are or provide any solid evidence that new cartilage is being created.

The good news is that some legitimate strides have been made for arthritis. Since 2016, there has been amazing work done by a Japanese surgeon who uses bone marrow stem cells derived from patients who are suffering from moderate knee arthritis. With an arthroscope surgery into the patient's hip, the surgeon extracts stem cells which are processed in a petri dish and developed as living tissue for 2 weeks and then ready for implantation into the patient's diseased knee cartilage.  After introduction into the joint with the existing cartilage, the stem cells begin to divide and grow into new cartilage, filling in areas that were previously worn. Post surgery measurements see new cartilage filling in and growing normally, thereby reducing or eliminating pain.

The surgeon has had good outcomes for last 2 years, but his goal is to be able to help those who lack cartilage completely in their knees, so he's working on that now. I believe other surgeons who are in the field of regenerative medicine are working with his method to tailor it to other joints, such as hips or shoulders. I'm hoping it won't be more than another few years away, but as for now this is the only procedure I am aware of.

Until then, I do know many folks who've had hip replacements with good success, but this might be worth waiting if you can work through the pain.

Take care,

Holly

Regarding the question of whether you can regenerate the hip joint - according to research it CAN and DOES happen of it's own accord in cases of hip OA. It is perhaps possible that if you eliminate the cause of abnormal wear that it will 'regenerate' itself. This is taken from the NICE guidelines on OA:

"Hip osteoarthritis probably has the worst overall outcome of the three major sites considered in this guideline. As with the knee, relatively little is known about the natural history of symptomatic disease, but we do know that a significant number of people progress to a point where hip replacement is needed in 1 to 5 years. In contrast, some hips heal spontaneously, with improvement in the radiographic changes as well as the symptoms."

Now, as I've said in other posts - there is a very definite muscle imbalance associated with hip OA that WILL cause abnormal wear of the joints AND will cause pain and stiffness. If you eliminate the imbalance it is POSSIBLE that the joint will regenerate to a degree.

However, it really doesn't matter as research also shows that many people function just fine with completely trashed joints. For example, knee and hand OA very often runs it's course without any intervention and people end up pain free. Again, the following is lifted from the NICE guidelines:

"The need to consider osteoarthritis of the knee, hip and hand as separate entities is apparent from their different natural histories and outcomes.

Hand osteoarthritis has a particularly good prognosis. Most cases of interphalangeal joint osteoarthritis become asymptomatic after a few years, although patients are left with permanent swellings of the distal or proximal interphalangeal joints (called Osteoarthritis Introduction National Clinical Guideline Centre, 2014 17 Heberden’s and Bouchard’s nodes respectively). Involvement of the thumb base may have a worse prognosis, as in some cases this causes continuing pain on certain activities (such as pinch grip), and thus lasting disability.

Knee osteoarthritis is very variable in its outcome. Improvement in the structure of the joint, as shown by radiographs, is rare once the condition has become established. However, improvement in pain and disability over time is common. The data on clinical outcomes, as opposed to radiographic changes, is sparse, but it would seem that over a period of several years about a third of cases improve, a third stay much the same, and the remaining third of patients develop progressive symptomatic disease. Little is known about the risk factors for progression, which may be different from those for initiation of the disease, but obesity probably makes an important contribution."

I Have Arthritic in the hip. What can i do to become pain free

INGREDIENTS: 100% Hydrolyzed Collagen

FOR BEST RESULTS: BLEND IN JUICE

During the past decade, Hydrolyzed Collagen has become very much in demand, going out all over the world. For best absorption, the label recommends that the collagen powder be blended in juice. Thousands of people seem to have achieved best results following this advice.

Occasionally someone will express concern about taking in too much sugar when using juice for the blend. “I can’t take the sugar” is what they always say.

Here are a few reasons why such concerns are groundless:

Any fruit or vegetable juice can be used, including celery juice, cucumber juice, cabbage, kale, or any other juice.

Orange juice is the most popular, being the most common breakfast beverage.

Whatever juice you choose, we’re talking about 100% pure of course, no concentrates, nothing added, organic if possible.

Now fructose is the natural fruit sugar in juices. If pure, the juice will contain within it all the vitamins and enzymes necessary for its complete breakdown into its simplest carbohydrate components. That’s called digestion.

This metabolic process will not cause undue stress, abnormal insulin spiking, overtaxing the pancreas or any other adverse effect in the healthy individual. No matter what you might read on google-pedia.

Blood glucose will always be temporarily elevated following a meal that includes carbohydrates. That is a necessary sign of the digestive process. But it soon returns to normal levels between meals. Pure natural juices are not a cause of diabetes in today’s world. Just visit any supermarket and look down the double aisle of Coke, Pepsi, Dr Pepper, beer, etc. and see the real cause.

How much of that is in your kitchen?

You can actually mix the collagen powder in anything you want, and daily intake will eventually have a beneficial effect. The loading dose. But we have noticed over and over that pure organic juice seems to work best, for 2 likely reasons:

1. It is suspended in a most easily absorbable medium
2. whole food Vitamin C is an important co-factor in initiating the conversion of hydrolyzed collagen supplement into the body’s own new collagen.

So, yes you can dissolve the Hydrolyzed Collagen in water or applesauce or milk, or sprinkle it over oatmeal – or mix it into any wholesome food – all of that works. Except for coffee of course – which is a non food – no nutrient value, and will dilute the value of this excellent supplement. (Yes, yes, I read that too – it’s nonsense. )

But for optimum results, most people just use the best organic fruit or vegetable juice they can find. That’s what most of those dramatic success stories in the Feedback section did.

So just forget about any imaginary issues about too much sugar, etc. Fruit juice is not the reason why almost 30% of the US population is diabetic!

It would be intriguing to be able to look into the refrigerators and kitchen cupboards of some of these callers who are so worried about the ‘sugar’ in organic orange juice. Of course we’d find absolutely no Coke, soft drinks, cookies, donuts, liquor, beer, wine, cakes, pies, candy, chocolate, etc, just lying around…

I know, right? So please stop calling with this question! If you just spent the money, keep reading:

WHAT IS COLLAGEN?

A polypeptide molecule, collagen is a protein in our bodies. In fact, collagen is the largest and most abundant protein in the body, making up about 30% of our total protein.

Proteins are made of amino acids, such as glycine, proline, arginine, hydroxyproline, which are amino acids that exist in collagen in varying proportions, depending upon the source. As the largest protein in the body, collagen is a chain of over 1500 amino acids.

Collagen is the connective tissue for almost all our structures, including

heart……………lungs……….arteries………discs……….blood cells

skin…………….muscles…….bones………..cartilage……..liver

other organs……hair…………joints………..nails…………prostate

As we age, collagen production drops way off, and any of these systems can be affected. Most common example of collagen decrease: the floorward tendency of our skin and muscles as we age, which doctors call ptosis.

In the organs, decreased collagen causes instability and weakness. Organs like the heart and prostate may enlarge; other organs just get flimsier and weaker. For this type of degenerative problem, drugs simply don’t work.

Why does collagen production decrease? Hormonal changes, drugs, alcohol, processed food, white sugar, hydrogenated oils, overwork, radiation, fluoridated water, excess sun, nutritional deficits, dehydration, stress, trauma.

COLLAGEN LOSS

What else happens as collagen production decreases? Muscles and skin sag. The bones lose density. The joints and ligaments become weaker and less elastic. Cartilage becomes thinner and weaker at the joints it is supposed to cushion. Hair loses its wave or curl or thickness. Organs may sag toward the floor (prolapse), and may malfunction. The lungs turn to paper. The heart weakens and enlarges. The liver and prostate may weaken and enlarge. The arteries weaken and are less able to resist plaque formation. Also they are more likely to develop a break in one of their 3 layers (aneurysm). The skin becomes thinner and it wrinkles.

Ever notice that kids never lick their fingers for friction when thumbing through the pages of a book – only adults do? Collagen breakdown. Ever notice that plastic surgeons often own large houses overlooking the ocean? Collagen breakdown.

COLLAGEN DIGESTION

Normal digestion breaks down protein into peptides and amino acids, which are then absorbed into the bloodstream.

For the collagen protein found in foods and most supplements to be utilized by the body, it must first be broken down many times by the digestive system, and then absorbed through the intestine into the blood in the precise form needed. It’s then reassembled into your collagen at the proper site. Protein digestion of dietary collagen is often incomplete, resulting in some very large peptide chains. These long molecules are not well utilized in the body’s efforts to keep up with the declining production.

This is why eating beef, for example. in order to gain muscle mass is an inefficient and metabolically expensive process.

A BETTER IDEA: HYDROLYZED COLLAGEN

With high end collagen supplements, the protein breakdown is already done, resulting in a more uniform result: usable small chain peptides and amino acids, ready to go. Hydrolyzed collagen radically increases the amount of usable protein in the diet.

Highest quality hydrolyzed collagen supplements are made from cattle hides. All mammalian collagen is structurally identical: including bovine and human. The cattle skin’s outer layer is split from the inner layer. The outer layer is used in the leather industry. The inner layer provides the raw material for a highly technical, multi-step process whose final result is Hydrolyzed Collagen.

This Hydrolyzed Collagen is sourced from grass fed beef, although that’s more a consideration for food products than forsupplementation.

The raw unprocessed collagen contains all essential human amino acids except tryptophan, including

Glycine

Proline

Hydroxyproline

Glutamic acid

Alanine

Arginine

Aspartic acid

Glycine

Tryptophan is unnecessary to make structural collagen in mammals.[17]For 100 years, other companies have been using the inner split to manufacture gelatin. Gelatin has been used for decades in the food industry as a thickening, emulsifying, and jelling agent. Examples: marshmallows, candies, health bars, jello, custards, fillings, canning, etc.

There is even a grade of gelatin that is actually used in hospitals as a blood plasma substitute. So we might imagine the strict QC standards for sterility and cleanliness in place in producing collagen of this quality.High end hydrolyzed collagen as a food supplement came about later on, but does not come from gelatin. Scientists learned to bypass that step and to break the raw material’s long chain triple helix protein into shorter pieces, and then to separate the 3 helices from each other. The resulting short individual peptides make up hydrolyzed collagen.

Cleaving peptides into sections is known as hydrolysis.

MOLECULAR WEIGHT

We saw that one determinant of Hydrolyzed Collagen’s ultimate quality is molecular weight, or size of the finished molecules. The unit of molecular weight is the dalton. The molecular weight of a batch of collagen, although expressed as a single number in daltons, is actually an average size within a range.

Commercial collagens sold as food supplements today can run from 10,000 daltons up to more than 50,000 daltons, depending upon processing. The average is near 45,000. For optimum bioavailability, or uptake at the cellular level, small is better. The lower the number of daltons, the smaller the molecule, the greater the bioavailability.

Below 2000 daltons there would be too many free amino acids, which would give the collagen a very harsh taste. At 3000 daltons, hydrolyzed collagen gives a neutral taste – actually no taste when mixed with fruit juice. This is the optimum molecular size for the best repair usefulness by the body.

Bioavailability is a prime criterion in evaluating any supplement, not just collagen: how much of the supplement actually gets absorbed at the cellular level. Bioavailability is expressed as a percentage, the higher the better, meaning that the greatest percentage of the supplement actually enters the body’s cells.

The 3000 dalton range is more than 15x better than most. Its bioavailability approaches 90%, digested and absorbed [ 2, Asghar] Other studies showed 95% bioavailability by radio-assay testing. [3, Oesser]

By contrast, most health supplements sold in mall stores have very cheap ingredients, which result in very low bioavailability, perhaps in the area of 5% or even less. Many pills, as in most of the multi products, do not even dissolve at all and pass through the body intact. That would obviously be about a 0% bioavailability.

DOSAGE

Hydrolyzed Collagen comes in a big pouch: 1.1 lbs.

Dosage varies from 2 – 6 tablespoons per day, blended in juice.

How much should you take?

Acute conditions, injuries, arthritis, etc : 3 tablespoons twice a day, blended in juice.

Maintenance dose, or detox program: 2 tablespoons per day, blended in juice. May be done 2x per day if needed.

This is not a pharmaceutical – precise amounts are not critical. You could probably take a whole jar in one day with no adverse effects. But that would be wasteful. Maximum absorbed amount would be in the vicinity of 6 tablespoons per day, for most adults.

More important is the concept of LOADING DOSE. That means in order to really give this supplement a fair try, you have to take it every single day, until you go through 2 full jars. Don’t miss a day or you’re wasting money! Loading dose. Only then will you be able to say you really gave it a try. All the remarkable stories you can read in the Feedback section did just that.

Why blended in juice? Much better absorption if the collagen is suspended, we found out. Therefore better results. Any kind of fruit or vegetable juice – organic is better of course, no concentrates, sugar, or other additives.

TYPE I OR TYPE II?

People call all the time and want to know if it’s Type I or Type II. This indicates 3 things:

They’re at the very beginning of an understanding of collagen

They skimmed some superficial articles off google/wiki or one of the low-end collagen sites.

They never read this chapter.

There’s a short answer and a long answer to this question.

Short answer: it’s both, but Type is a non-issue and not relevant to rebuilding human structures. Type I and Type II are 95% identical. It’s the wrong question for the new shopper. They really should be asking about things like sources and bioavailability, which do vary widely within the industry.

Long answer: (OK to skip this unless you have some college science)

When we’re talking about types, you have to specify, are you talking about the supplement, or the type of tissue you’re trying to strengthen in your own body? There are at least 16 types of collagen in the mammalian body, but most of it is Types 1, 2, and 3.

With our Hydrolyzed Collagen, the source is primarily bovine Type 1. Grass fed, of course, no hormones, antibiotics, etc. But because of its small molecular weight, this collagen can repair many different types of tissues within the body, and all the structural tissues.

So, stop reading the contradictory overintellectualized ‘science’ papers trying to figure what’s best by Type, and look at the dozens of stories on the Testimonials page of real patients with real problems – from cancelling joint replacement surgery – to chronic arthritis, prostate, and much more—

Don’t miss your chance to see if this is the missing piece of the puzzle in your health picture.

Want to get more technical?

TYPE I triple helix:

2 ALPHA

1 BETA

The 2 Alpha helices are identical. The beta helix is only 7% different.

TYPE II

3 ALPHA HELIXES

Therefore the 2 Types are over 95% identical, with only a very few peptides different.

This is why asking “is the supplement Type I or Type II/” is irrelevant, because after hydrolysis, at 3000 daltons average size, there’s no way to tell which type any one peptide came from.

SORRY MADAM: EVOLUTION SHORT-CHANGED YOU

You’re not gonna like this, ladies, but men’s skin is more resistant to aging than women’s. It’s a physiological fact, and it’s incontrovertible.

Why? The short answer is that for the structural advantage for stretchability of the skin, selected for in childbearing, throughout aeons of mammalian evolution, there’s a downside.

Male dermis has a beneficial structural cross linking, a consequence of male hormones. Selected for by hunting activities, as genetic anthropologists will tell you.

Women’s skin lacks this inborn cross linking, because the lines of skin collagen are formed primarily almost perpendicular from the surface of the skin. Straight in. The result is slightly thinner skin, but extremely more elastic.[17]

This is why those little Chinese gymnast children you see at Cirque de Soleil are never boys. They’re always little girls – extraordinarily elastic. Later on, in the childbearing years, this characteristic comes in very useful, which still applies even to women who give birth in their late 40s. It’s hormonal, directly related to the XX chromosome.

Too bad, but consequently women are prone to the ‘orange peel’ look of the skin’ As the dermis becomes thinner, and fat cells increase, the thin dermis may mold around the bumpy fat cells underneath, giving the classic orange peel look.

This is why women are often willing to rush off to any plastic surgeon who promises to tighten things up a little. It can sometimes help. But there’s a much less expensive, natural and noninvasive first resort: Hydrolyzed Collagen.

This is from the NATIONAL INSTITUTE OF HEALTH:

A Comprehensive Review of Stem Cells for Cartilage Regeneration in Osteoarthritis.

Kalamegam G1,2, Memic A3, Budd E4, Abbas M2,5, Mobasheri A6,7,8,9.

Author information

Abstract

Osteoarthritis (OA) is an age related joint disease associated with degeneration and loss of articular cartilage. Consequently, OA patients suffer from chronic joint pain and disability. Weight bearing joints and joints that undergo repetitive stress and excessive 'wear and tear' are particularly prone to developing OA. Cartilage has a poor regenerative capacity and current pharmacological agents only provide symptomatic pain relief. OA patients that respond poorly to conventional therapies are ultimately treated with surgical procedures to promote cartilage repair by implantation of artificial joint structures (arthroplasty) or total joint replacement (TJR). In the last two decades, stem cells derived from various tissues with varying differentiation and tissue regeneration potential have been used for the treatment of OA either alone or in combination with natural or synthetic scaffolds to aid cartilage repair. Although stem cells can be differentiated into chondrocytes in vitro or aid cartilage regeneration in vivo, their potential for OA management remains limited as cartilage regenerated by stem cells fails to fully recapitulate the structural and biomechanical properties of the native tissue. Efficient tissue regeneration remains elusive despite the simple design of cartilage, which unlike most other tissues is avascular and aneural, consisting of a single cell type. In this article, we have comprehensively reviewed the types of stem cells that have been proposed or tested for the management of OA, their potential efficacy as well as their limitations. We also touch on the role of biomaterials in cartilage tissue engineering and examine the prospects for their use in cell-based therapies.

KEYWORDS:

Chondrocytes; In vitro; In vivo; Osteoarthritis; Regenerative medicine; Stem cells

PMID: 29725971 DOI: 10.1007/5584_2018_205

The Mayo Clinic is working on it, but until something works, its best to keep the muscles supporting the hip strong with physical therapy routines.

Research Grant Recipient: Elizabeth W. Bradley, PhD

Grant Period: 2015-2017

Award Value: $500,000

Site: Mayo Clinic

Click here to read Bradley's First Year Progress ReportClick here to see progress video Click here to read Bradley's Final Progress Report

Osteoarthritis is one of the leading causes of disability in the US today. The disease occurs when articular cartilage in a joint degenerates. Articular cartilage is the smooth, white tissue that covers the ends of bones where they come together to form joints. It doesn’t regenerate in the same way as other tissue in the body. Articular cartilage allows the bones to glide over each other with very little friction, and it’s essential to movement. As osteoarthritis takes hold, it becomes progressively more painful and difficult to move.

The only way to currently cure osteoarthritis is through joint replacement surgery. It’s not ideal, we don’t have implants available for every joint, and infection is always a risk. Even when a joint replacement is available, it doesn’t last a lifetime. That means young and middle age adults will need to undergo another surgery again later in life.

A treatment that could cure the disease by promoting articular cartilage to heal in the same way as other tissues in the body would give countless patients a less intrusive medical alternative to a joint replacement surgery. Researchers have found a gene, the Phlpp1 (pronounced “flip”) that stops regeneration in cartilage. If we can block the Phlpp action, then cartilage could possibly repair itself. That means there could be a treatment for osteoarthritis other than joint replacement.

Two chemical inhibtors have been found to block Phlpp activity and slow down the progression of osteoarthritis in mice. That’s a great step, but researchers don’t know if that would work in people. The focus of this grant is to test whether or not human articular cartilage can be regenerated when the Phlpp actions are blocked. It’s called the “Phlpp knockout”, and it could be an incredible option for osteoarthritis patients.

This grant will support researchers testing drugs to treat osteoarthritis and support the Phlpp knockout in humans. There are three possibilities that the team will observe. The first is a drug made of tiny molecules that block the gene stopping cartilage from regenerating. The second idea is to find out if it’s possible for adult stem cells to grow into cartilage by blocking the Phlpp activity. Third, this research will look at how controlling Phlpp activity could work on neocartilage, engineered tissue that could replace degenerated articular cartilage.

The researchers working on this grant are the first in the world to identify the Phlpp activity in cartilage regeneration. This is one of the only promising treatments for osteoarthritis being worked on today, and it puts Minnesota at the forefront of cartilage regeneration.

The only way for new osteoarthritis treatments to be developed is through further research funded by this grant. As federal support dries up, grants like this become increasingly more important. Therefore, the advancement of this research, with Regenerative Medicine Minnesota funding, could benefit osteoarthritis patients for generations to come.

Dr. Elizabeth W. Bradley is an assistant professor in the Department of Orthopedic Surgery at the Mayo Clinic in Rochester, Minnesota. She has developed a broad background in biochemistry and cell biology and has worked extensively with the Phlpp1 knockout in mice to prepare for this study on human articular cartilage. Bradley earned her PhD in Biochemistry at the Mayo Clinic in 2008 and served in fellowship and research positions at the University of Connecticut, Mayo Clinic, and the University of Minnesota before becoming a faculty professor at Mayo. She also earned many distinctions, particularly the K01 award for evaluating the effects of Phlpp1 on cartilage development from the National Institute of Health (NIH).

Dr. Jennifer J. Westendorf is the Margaret Amini Professor for Orthopedic Regenerative Medicine Research at Mayo Clinic in Rochester, Minnesota. She has extensive experience and expertise on skeletal development, and her independent and NIH-funded research lab has focused on identifying and analyzing the impact that Phlpp1 has on cartilage development and osteoarthritis disease progression. Their preliminary data show that Phlpp1 inhibition may prevent articular cartilage degradation in mouse models, findings that have led them to launch this RMM-funded study on human articular cartilage. Westendorf earned her PhD in Immunology at the Mayo Clinic in 1996 and previously served as a professor at the University of Minnesota. She also serves as an ad-hoc grant reviewer and editorial board member of multiple journals