In India, osteoarthritis (OA) is the second leading rheumatological problem. Affecting roughly 22 to 39% of the Indian population, OA causes pain, stiffness and restricted movement due to the degeneration of joint cartilage.

One of the most common forms of OA occurs in the knee. Knee osteoarthritis is linked to heavy physical labor, which is widespread across India’s rural communities. A 2016 study also found that the prevalence of OA was more common in India’s lower socioeconomic classes, leaving many of the affected people without the necessary resources to treat the condition.

As of now, there is no cure for knee osteoarthritis. Doctors typically promote non-pharmaceutical measures, like losing weight or trying certain exercises. There are some medical treatments that can alleviate pain, like hyaluronate injections, physical therapy and even surgery. But these treatments can be expensive and difficult to access, and people living in India’s rural villages may struggle to get to the right clinics.

Rising Risk Factors Among Women and the Elderly

Due to the growing elderly population in India, the prevalence of knee osteoarthritis will increase over the next few decades. According to the National Statistical Office’s (NSO) Elderly in India Report authored in 2021, India’s elderly population is expected to reach 194 million by 2031 – a 41% increase over the next decade. The report emphasized the country’s rapidly changing population structure and stressed the importance of addressing the health of India’s elderly.

Among the elderly population, women are at particular risk for knee OA. While it does tend to affect men more than women before age 45, the disease is more common in women aged 45 and older. In the NSO’s 2021 report, researchers stated there would be 93 million males and 100 million females in 2031. With the increase in the elderly population, and with the majority of the elderly being female, knee OA is becoming a larger concern in India.

In addition, there has also been significant research on other risk factors for knee OA, including the role of obesity, inactivity and manual labor jobs. As emphasized in a Nigerian study, the occupational risk factors in manual labor professions — such as farming, trading and artisanship — can put individuals at a higher risk for developing knee OA. Twisting, awkward postures, heavy lifting and bending and frequent movement can all cause knee OA.

Seeking a Solution

Although there is currently no cure for knee OA, a group of researchers in India has made a medical breakthrough. In September 2022, the Drug Controller General of India approved Stempeutics’ StemOne, a new stem cell therapy for knee OA. StemOne will become India’s first commercially-available allogeneic cell therapy treatment for knee OA.

The Bangalore-based biotech company, Stempeutics, created StemOne using healthy bone marrow. With anti-inflammatory and immunosuppressive properties aimed at reducing pain in the knee joint, the treatment can make daily tasks easier and the possibility of knee replacement surgery less likely. By stalling further deterioration in the joint cartilage, StemOne can deter future expenses and the lifelong disabilities caused by knee OA.

The treatment currently costs 125,000 Indian rupees, or roughly $1,500. Although a single injection can have effects lasting up to two years, the cost is still out of many peoples’ price range. For individuals with knee OA in rural communities or without the financial resources to afford StemOne, there are relatively few treatments available.

However, with more innovations like StemOne underway, there has been more attention on the prevalence of knee osteoarthritis in India. Because of these research efforts, there is hope that there will be more accessible treatment options for all affected individuals in the future.

– Anna Lee
Photo: Flickr