1. Evidenced-Based Medicine
Orthopaedic Department
TSMH

2. Clinical Scenario

3. A 62 Y/O female, suffering from bilateral knee joints pain off and on for years.
The S/S exacerbated recently, she called at our OPD seeking for treatment.
P.E. and X-ray examination revealed a typical O.A. of bilateral knee joints.

4. NSAIDs were prescribed in the first place.
However, the patient requested adding the “Glucosamine” as an alternative treatment.

6. Patient Intervention Control Outcome
PICO

7. P: a 62 Y/O female with OA knee
I: is Glucosamine effective in treating
OA knee
C: as opposed to not use
Glucosamine
O: reduce the knee pain of patients
with OA knee

8. Databases and Resources

9. PubMed
Cochrane library
UpToDate

10. Search Strategy

12. PubMed Search and resources strategy: Why I used what I used.
Search Engine: Clinical Queries in PubMed.
MeSH: Glucosamine AND osteoarthritis AND knee joint
Clinical Study Category: Therapy

13. Cochrane library/UpToDate
Key words: Glucosamine osteoarthritis

18. PubMed: 18 articles
Cochrane library: 1 article
UpToDate: 5 articles

19. Critical Appraisal

21. Conclusions

22. Glucosamine did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee.
Heterogeneity among trials of glucosamine is larger than would be expected.
Potential explanations include different glucosamine preparations, inadequate allocation concealment, and industry bias.

23. Implementation and Evaluation

24. Current pharmacologic therapy of osteoarthritis (OA) consists of analgesics, nonsteroidal antiinflammatory drugs, intraarticular glucocorticoids)..etc.
As Glucosamine is a complementary therapy, and the effectiveness not obvious, we here suggest our hospital discontinue using it and evaluate the outcome.

25. Thank You
Chih-Yu Eric Tu MD, MPH