Vertebral Joint Anatomy Joint Medicine.

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Presentation transcript:

Vertebral Joint Anatomy Joint Medicine

Two popular treatments for OA are sold as dietary supplements (therefore proof of efficacy or content of the supplement is not required): chondroitin and glucosamine. Chondroitin is a glycosaminoglycan, a large, hydrophilic, gel-forming polysaccharide which gives cartilage much of its ability to withstand compression. Glucosamine is a component of chondroitin. Chondroitin one subunit; portion derived from glucosamine highlighted Glucosamine Chondroitin and Glucosamine

The best current evidence is that chondroitin sulfate does not reduce joint pain in osteoarthritis. However, some patients are convinced that it helps, which could be because of a placebo response or even a therapeutic response resulting from enhanced absorption or limited metabolism of chondroitin. Because no frequent or severe adverse effects have been reported, chondroitin sulfate should not be considered dangerous. If patients say that they benefit from chondroitin, I see no harm in encouraging them to continue taking it as long as they perceive a benefit. D. Felson, MD, MPH Ann Intern Med. (2007) 146: Chondroitin If they think it works, let them use it

Glucosamine sulfate is no better than placebo in reducing the symptoms or progression of hip OA, according to a randomized, double-blind, placebo- controlled trial in the Netherlands (2008). 222 patients were treated for two years with glucosamine sulfate or placebo. Primary outcome measures were hip pain, hip function, and joint space (assessed radiographically, i.e. by X-ray images). (Joint space decreases as OA progresses.) Glucosamine sulfate was no better than placebo for any of the main outcome measures. Ann Intern Med. (2008) 148: Glucosamine no better than placebo