Behind the Scenes of Arthritis Research
Knee osteoarthritis affects at least 1 in 6 adults. The economic burden is in excess of $30 billion per year in healthcare system costs and lost productivity. And it’s one of the top causes of long-term disability. More than 70,000 knee replacements were performed in Canada between 2017 and 2018 and that number is on the rise.
“A lot of patients see surgery as the only option,” said Dr. Michael Hunt, Director of the Motion Analysis and Biofeedback Laboratory in the Department of Physical Therapy at the University of British Columbia, and an Affiliate Scientist at Arthritis Research Canada.
His team is currently working on a research project that seeks to find inexpensive and highly accessible treatment options for individuals who might not yet be candidates for knee replacement surgery. The end goal is to reduce pain and improve function and overall quality of life.
“A big dream would be to prevent the need for knee replacements, but the current goal is to prolong the need for surgery,” Dr. Hunt said. “I always use the term ‘another tool in the toolbox.’ We give people different options to try out, so they can see what works for them.”
Like all studies at Arthritis Research Canada, patients play a key role in research conducted at the Motion Analysis and Biofeedback Laboratory.
“We involve patients to figure out what is important to them, and to drive the research to areas that will be highly utilized,” Dr. Hunt said. “If we didn’t involve patients, we would run the risk of developing treatments that no one wants or uses.”
Shauneen Kellner is Arthritis Research Canada’s Executive Director. She has worked for the organization for 16 years and has seen first-hand the value of patient involvement. But when Dr. Hunt’s recruitment notice crossed her desk, she decided to do something different. She signed up to participate.
Kellner has knee OA in both knees and struggles with pain, stairs and mobility.
“When I started here 16 years ago I didn’t have knee OA. It’s something that can happen to anyone, even those of us who live and breathe this every day,” she said. “We don’t have all the answers for osteoarthritis and, without research, we can’t alleviate the pain or damage. So I wanted to lead by example.”
But what does participating in research really look like?
Reflective markers are used to track movements and create a stick-figure. This gives researchers an idea of the forces going through the different joints and the impact in the knee.
Kellner arrived at the lab and was fitted with reflective markers on her skin to track her movements. She was then asked to walk down a runway normally, but with different types of insoles in her shoes.
“We’re looking to see whether patients perceive the insoles as more or less comfortable,” Dr. Hunt said.
Researchers then used equipment to determine where the loads were predominantly situated inside Kellner’s knee joint, with the goal of shifting loads away from the more highly loaded areas of the joint.
“It was such a good learning experience. I discovered a lot about my disease and the research that can help others, like me, struggling with knee osteoarthritis,” Kellner said.
She encourages individuals with OA to participate in arthritis research if they fit the criteria.
“It’s about changing the future for people with this disease. Patients play an important role in solving health-related problems,” she added.
Knee osteoarthritis is not just a disease of the elderly. In fact, 20 per cent of people between the ages of 15 and 26, who had a knee injury before the age of 18, have early osteoarthritis. So some Canadians are getting diagnosed in their twenties and will have to live with, and manage, knee osteoarthritis until age 80 or 90.
“People suffer with this disease for years and there are large costs incurred with treatment,” Dr. Hunt said. “We are trying to give them different options and reduce pain and the economic burden on the healthcare system, people relying on pharmaceuticals for the rest of their lives, experiencing loss of employment productivity and much more.”