Knee and hip injuries, including combat-related fractures, shrapnel wounds, and ligament tears, can lead to joint degeneration, a disease called post-traumatic osteoarthritis. This chronic condition causes intense pain and limits quality of life. In fact, the number one cause of disability among veterans is osteoarthritis. Current treatment options are limited to medications that control pain but which can damage the liver, kidney, and heart when used long term. Joint injection therapy with cortisone can also provide some relief, but the benefit is short term and there is a risk it may make the joint degenerate more quickly. Ultimately, none of these current treatments slow down the progressive course of the disease, and joint replacement surgery is often needed.

The ideal treatment for post-traumatic osteoarthritis would be a joint injection that is administered soon after joint injury, which delivers medication in proportion to how quickly the joint is breaking down. This medication would then reduce pain and prevent joint degeneration. Since the drug would only be released within the joint, this type of injection should also provide very low systemic toxicity with few, if any, side effects. Here we propose to develop a medication delivery system based on hydrogels that release drugs to reduce inflammation and preserve the joint structure after injury. This transformative approach could be broadly applied to any drug being developed for post-traumatic osteoarthritis and to other local diseases where limiting systemic side effects would be beneficial.

We anticipate that success with the proposed project would position the technology for first-in-human trials within 3-5 years.