Can growth hormone improve osteoarthritis?

Growth Hormone Does Not Improve Osteoarthritis and May Worsen Joint Health

Based on the current evidence, growth hormone is not recommended for the treatment of osteoarthritis and may actually worsen joint health by triggering inflammation-associated arthropathy and subchondral bone loss. 1

Pathophysiological Effects of Growth Hormone on Joints

Growth hormone (GH) plays a critical role in skeletal development, but its effects on osteoarthritic joints appear to be detrimental rather than beneficial:

• Excess GH triggers inflammatory responses: Research shows that excess GH leads to severe inflammatory responses in joint tissues, unlike the low-grade inflammation seen in primary osteoarthritis 1
• Negative joint effects: GH excess causes:
  • Severe loss of articular cartilage matrix
  • Osteophyte formation
  • Synovitis
  • Ectopic chondrogenesis 1
• Bone deterioration: Excess GH is associated with significant reductions in trabecular thickness and reduced bone mineral density in the subchondral bone plate 1
• Pain sensitivity: Animal models with excess GH demonstrate increased sensitivity to mechanical and thermal stimuli 1

Evidence Against GH for Osteoarthritis

The most recent and highest quality evidence strongly suggests that GH may worsen joint health:

• A 2023 study demonstrated that excess GH triggers inflammation-associated arthropathy, subchondral bone loss, and arthralgia 1
• Chronic GH/IGF-1 deficiency has been associated with increased severity of articular cartilage lesions, suggesting a complex relationship between GH levels and joint health 2

Limited Evidence for Potential Benefits

While some limited evidence suggests potential benefits:

• A 2003 study in micropigs showed that systemic GH administration may accelerate healing of osteochondral defects by stimulating bone and cartilage formation 3
• However, this study focused on acute defect healing rather than chronic osteoarthritis management

Clinical Implications and Recommendations

When considering treatment options for osteoarthritis:

1. Avoid GH therapy: The current evidence suggests GH may worsen joint inflammation and damage
2. Consider established treatments: Follow evidence-based guidelines for osteoarthritis management
3. For glenohumeral osteoarthritis specifically:
   • Injectable viscosupplementation may be considered as a treatment option 4
   • For severe cases requiring surgical intervention, total shoulder arthroplasty is suggested over hemiarthroplasty 4

Pitfalls and Caveats

• Despite theoretical benefits of growth factors for cartilage health, systemic GH administration appears to have predominantly negative effects on osteoarthritic joints
• The relationship between GH and joint health is complex and likely depends on local tissue concentrations rather than systemic levels
• Patients with acromegaly (excess GH) commonly develop severe arthropathies, further supporting the detrimental effects of excess GH on joint health 1

In conclusion, current evidence does not support the use of growth hormone for osteoarthritis treatment, and its use may potentially accelerate joint deterioration through inflammatory mechanisms.