Gold implantation

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The gold implantation is a method for pain and inflammation treatment of joints in people with osteoarthritis characters and one of the alternative medical methods. In animals, especially dogs and cats, gold implants are used in addition to pain therapy for joints to treat scar tissue pain, inflammation of the gums and inflammatory skin diseases. There is no scientific evidence in sufficiently good studies.

History of gold implantation

In 1975, Terry Durkes, an American veterinarian of Marion, Indiana, began treating dog hip dysplasia with gold implants on acupuncture points . The method is now also used on pets (dogs, cats, horses). There are currently around 20 studies in veterinary medicine, the research results of which, however, were not considered to be transferable to human medicine. In 1996 the Danish general practitioner Hans Kjerkegaard from Aarhus used the method for the first time in human medicine.

methodology

Different methods have been developed for gold implantation, leading to different schools and traditions of the method in both humans and animals. There are essentially two fundamental views on the mechanism of action of gold implantation: One is based on the hypothesis that gold implants lead to a permanent acupuncture effect in the sense of a permanent stimulus . This view on which the “gold acupuncture” is based has since been abandoned by some users. The gold implantation at the individual pain points , mostly near the joints , which are determined by palpation before the procedure , takes a different view. The implantation takes place here detached from the acupuncture thought. This is based on the assumption that the intrinsic effect of gold is responsible for the pain therapeutic effect.

Classic gold implantation

X-rays of a knee joint with severe (fourth-degree) osteoarthritis and gold implants

With the classic piece of gold implantation, small cylindrical segments (about 1 to 3 millimeters) made of 24-carat gold wire with a diameter of 1 millimeter are implanted close to the joint. The segments are placed around the joint in local anesthesia in humans and in sedation in animals using a hollow needle. The pieces are on the outside of the joint capsule, not in the joint. The number varies between 10 and 50 pieces, depending on the joint. The gold wire segments will stay in place after surgery and will not wander.

Hypothetical effect of gold implantation

The gold implantation is said to be effective in treating degenerative, traumatic or inflammatory joint changes that are associated with pain, such as in the knees, hips, fingers, toes, back (cervical, thoracic and lumbar spine), shoulder and ankle. The main goal is to eliminate the pain by reducing the inflammation, often followed by an increase in mobility. The cartilage wear and tear on the joint is naturally irreversible.

Various mechanisms of action of gold are discussed at the molecular biological level. The earlier assumption that gold, as a precious metal, is largely inert (neutral) in the body is considered refuted. In 2002 it was shown that after gold particles have been implanted in mammals, gold ions are released into the surrounding tissue.

Some studies on gold implantation therefore assume that the findings from research on gold salts can be transferred to gold implantation, but avoiding the side effects associated with gold salts.

Other studies specifically examine the effects of gold ions without reference to gold salts. The local introduction of pure gold appears to influence the immune system. In laboratory studies, gold inhibited the release of the cytokine HMGB1 from macrophages, which also triggers the inflammatory reaction. In addition, a research team was able to detect gold ions in mast cells (immune cells) and macrophages (scavenger cells) in animal experiments . A possible gene regulatory, immunomodulating effect of gold ions was shown in laboratory tests in 2012. The exact biochemical process and the importance of this anti-inflammatory effect of gold are not known.

Side effects or allergies to pure gold (fine gold) have not yet been described. With gold salts and gold alloys, as used in dentistry or in artificial joints, side effects in the form of intolerance reactions and type 4 allergies have been described.

So far there are no scientific studies that show its effectiveness in humans, and accordingly there are no recommendations in medical guidelines. The Danish developers of the therapy have scientifically published only one pilot study . In this randomized, blinded study with 43 patients, however, there was no difference between the group with gold implants and the control group. Accordingly, no further scientific research was carried out, but the process will continue to be advertised.

The majority of the studies involve pets (especially dogs) and it is not easy to extrapolate the results. In addition, there is no proof of the mode of action outside of laboratory tests and in-vitro experiments.

Individual evidence

  1. ↑ a b T. E. Durkes: Gold bead implants. In: Probl Vet Med. No. 4, 1992, pp. 207-211.
  2. ↑ a b A. Deisenroth: Use of gold implants for pain therapy in canine hip dysplasia: An overview of the method, mechanism of action and effectiveness of gold wire implantation. Vet. Med. Diss., TiHo Hannover 2014.
  3. ^ AA Thoresen: "New" Method of Placing Gold Implants to Treat Hipdysplasia in Dogs. In: Proceedings of the Twenty-Second Annual International Congress on Veterinary Acupuncture. 5-8. September 1996, Spiez / Switzerland. Edited by IVAS. 1996.
  4. ↑ C. Winkler: Comparative examinations of radiological and arthroscopic findings on the dog's hip joint. Dissertation at the clinic for small animals of the University of Veterinary Medicine Hannover 2008.
  5. ↑ O. Kothbauer: About the implantation of gold particles for the therapeutic influence of painful processes in the hip joint area of ​​dogs - illustrated by three case studies. In: Tierärztl Mschr. 84, 1997, pp. 47-52.
  6. ↑ a b K. Zainali, G. Danscher, T. Jakobsen, SS Jakobsen, J. Baas, P. Moeller, JE Bechtold, K. Soballe: Effects of gold coating on experimental implant fixation. In: Journal of Biomedical Materials Research. 88, 2009, pp. 274-280.
  7. ↑ a b G. Danscher: In vivo liberation of gold ions from gold implants: autometallographic tracing of gold in cells Adjacent to metallic gold. In: Histochem Cell Biol. No. 117, 2002, pp. 447-452.
  8. ↑ a b A. Larsen, K. Kolind, DS Pedersen, P. Doering, M. Ostergaard Pedersen, G. Danscher, M. Penkowa, M. Stoltenberg: Gold ions bio-released from metallic gold particles reduce inflammation and apoptosis and increase the regenerative responses in focal brain injury. In: Histochem Cell Biol. 130, 2008, pp. 681-692.
  9. ↑ MO Pedersen, A. Larsen, SP Pedersen, M. Stoltenberg, M. Penkowa: Metallic gold reduces TNFα expression, oxidative DNA damage and pro-apoptotic signals after experimental brain injury. In: Brain Res. 1271, 2009, pp. 103-113.
  10. ↑ CK Zetterström et al .: Pivotal advance: inhibition of HMGB1 nuclear translocation as a mechanism for the anti-rheumatic effects of gold sodium thiomalate . In: J Leukoc Biol. No. 83 , 2008, p. 31-38 , PMID 17913975 .
  11. ↑ MO Pedersen, A. Larsen, DS Pedersen, M. Stoltenberg, M. Penkova: Metallic gold treatment reduces proliferation of inflammatory cells, increases expression of VEGF and FGF, and stimulates cell proliferation in the subventricular zone following experimental traumatic brain injury. In: Histol Histopathol. Vol. 24, 2009, pp. 573-586.
  12. ↑ O. Seifert, A. Matussek et al.: Gene expression profiling of macrophages: Implications for an immunosuppressive effect of dissolucytotic gold ions. In: Journal of Inflammation. No. 9, 2012.
  13. ↑ K. Nejrup et al. a .: Randomized controlled trial of extraarticular gold bead implantation for treatment of knee osteoarthritis: a pilot study . In: Clinical Rheumatology . tape 27 , no. 11 , May 24, 2008, ISSN  0770-3198 , p. 1363-1369 , doi : 10.1007 / s10067-008-0918-9 .