Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 25, Issue 1 , Pages 86-94 , January 2009

A Review of Evidence-Based Medicine for Glucosamine and Chondroitin Sulfate Use in Knee Osteoarthritis

  • C. Thomas Vangsness Jr., M.D.

      Affiliations

    • Corresponding Author InformationAddress correspondence and reprint requests to C. Thomas Vangsness Jr., M.D., Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1520 San Pablo St, Suite 2000, Los Angeles, CA 90033, U.S.A.
    • ,
  • William Spiker, M.D.
    • ,
  • Juliana Erickson, B.A.

References 

  1. Adachi N, Ochi M, Deie M, Ito Y, Izuta Y. Lateral compartment osteoarthritis of the knee after meniscectomy treated by the transplantation of tissue-engineered cartilage and osteochondral plug. Arthroscopy. 2006;22:107–112
  2. Spahn G, Mückley T, Kahl E, Hofmann GO. Factors affecting the outcome of arthroscopy in medial-compartment osteoarthritis of the knee. Arthroscopy. 2006;22:1233–1240
  3. Ikeuchi M, Takahashi T, Tani T. Localized synovial hypertrophy in the anteromedial compartment of the osteoarthritic knee. Arthroscopy. 2005;21:1457–1461
  4. Bae DK, Yoon KH, Song SJ. Cartilage healing after microfracture in osteoarthritic knees. Arthroscopy. 2006;22:367–374
  5. Stuart MJ, Lubowitz JH. What, if any, are the indications for arthroscopic debridement of the osteoarthritic knee?. Arthroscopy. 2006;22:238–239
  6. US Senate Committee on Health, Education, Labor and Pensions, Subcommittee on Aging. Center for Disease Control's role in combating the burden of arthritis. Washington, DC: Department of Health & Human Services; 2004;
  7. Fries JF, Williams CA, Block DA, Michel BA. Nonsteroidal anti-inflammatory drug-associated gastropathy: Incidence and risk factor models. Am J Med. 1991;91:213–222
  8. Deeks JJ, Smith LA, Bradley MD. Efficacy, tolerability, and upper gastrointestinal safety of celecoxib for treatment of osteoarthritis and rheumatoid arthritis: Systematic review of randomised controlled trials. BMJ. 2002;325:619
  9. Vetter G. Topical therapy of arthroses with glucosamine (Dona 200). Munch Med Wochenschr. 1969;11:1499–1502(in German)
  10. Theodasksi J, Adderly B, Fox B. The arthritis cure. New York, NY: St Martin's; 1997;
  11. Bucsi L, Poór G. Efficacy and tolerability of oral chondroitin sulfate as a symptomatic slow-acting drug for osteoarthritis (SYSADOA) in the treatment of knee osteoarthritis. Osteoarthritis Cartilage. 1998;6(suppl A):31–36
  12. Bourgeois P, Chales G, Dehais J, Delcambre B, Kuntz JL, Rozenberg S. Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3 × 400 mg/day vs placebo. Osteoarthritis Cartilage. 1998;6:25–30
  13. Conrozier T. Anti-arthrosis treatments: Efficacy and tolerance of chondroitin sulfates (CS 4&6). Presse Med. 1998;27:1862–1865(in French)
  14. Mazieres B, Combe B, Phan Van A, Tondut J, Grynfeltt M. Chondroitin sulfate in osteoarthritis of the knee: A prospective, double blind, placebo controlled multicenter clinical study. J Rheumatol. 2001;28:173–181
  15. Mazieres B, Hucher M, Zaim M, Garnero P. Effect of chondroitin sulfate in symptomatic knee osteoarthritis: A multicentre, randomised, double-blind, placebo-controlled study. Ann Rheum Dis. 2007;66:639–645
  16. Uebelhart D, Malaise M, Marcolongo R, et al. Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: A one year, randomized, double-blind, multicenter study versus placebo. Osteoarthritis Cartilage. 2004;12:269–276
  17. Mathieu P. Radiological progression of internal femoro-tibial osteoarthritis in gonarthrosis (Chondro-protective effect of chondroitin sulfates ACS4-ACS6). Presse Med. 2002;31:1386–1390(in French)
  18. Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: A randomized, controlled trial. Arthritis Rheum. 2005;52:779–786
  19. Rothenfluh DA, Reedwisch D, Müller U, Ganz R, Tennant A, Leunig M, et al. Construct validity of a 12-item WOMAC for assessment of femoro-acetabular impingement and osteoarthritis of the hip. Osteoarthritis Cartilage. 2008;16:1032–1038
  20. Noack W, Fischer M, Förster KK, Rovati LC, Setnikar I. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994;2:51–59
  21. Reichelt A, Forster KK, Fischer M, Rovati LC, Setnikar I. Efficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee (A randomised, placebo controlled, double-blind study). Arzneimittelforschung. 1994;44:75–80
  22. Reginster JY, Derolsy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: A randomized, placebo-controlled clinical trial. Lancet. 2001;357:251–256
  23. Pavelká K, Gatterová J, Olejarová M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis. Arch Intern Med. 2002;162:2113–2123
  24. Bruyere O, Pavelka K, Rovati LC, et al. Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: Evidence from two 3 year studies. Menopause. 2004;11:138–143
  25. Bruyere O, Honore A, Ethgen O, et al. Correlation between radiographic severity of knee osteoarthritis and future disease progression (Results from a 3-year prospective, placebo-controlled study evaluating the effect of glucosamine sulfate). Osteoarthritis Cartilage. 2003;11:1–5
  26. Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum. 2004;51:738–745
  27. Herrero-Beaumont G, Ivorra JA, Del Carmen Trabada M, et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: A randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. 2007;56:555–567
  28. Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee. Rheumatology (Oxford). 2002;41:279–284
  29. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol. 1999;26:2423–2430
  30. McAlindon TE, Formica M, LaValley M, Lehmer M, Kabbara K. Effectiveness of glucosamine for symptoms of knee osteoarthritis: Results from an internet-based randomized double-blind controlled trial. Am J Med. 2004;117:643–649
  31. Clegg D, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354:795–808
  32. Kaptchuk TJ. The placebo effect in alternative medicine: Can the performance of the healing ritual have clinical significance?. Ann Intern Med. 2002;136:817–825
  33. Alekseeva LI, Chichasova NV, Benevolenskaia LI, Nasonov EL, Mendel' OI. Combined medication ARTRA in the treatment of osteoarthrosis. Ter Arkh. 2005;77:69–75(in Russian)
  34. Messier SP, Mihalko S, Loeser RF, et al. Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: A preliminary study. Osteoarthritis Cartilage. 2007;15:1256–1266
  35. McAlindon TE, LaValley MP, Gulin JP, et al. Glucosamine and chondroitin for treatment of osteoarthritis: A systematic quality assessment and meta-analysis. JAMA. 2000;283:1469–1475
  36. Richy F, Bruyere O, Ethgen O, Cucherat M, Henrotin Y, Reginster JY. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: A comprehensive meta-analysis. Arch Intern Med. 2003;163:1514–1522
  37. Bjoral JM, Kloving A, Ljunggren AE, Slordal L. Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: A meta-analysis of randomized placebo-controlled trials. Eur J Pain. 2007;11:125–138
  38. Distler J, Angueloouch A. Evidence-based practice: Review of clinical evidence on the efficacy of glucosamine and chondroitin in the treatment of arthritis. J Am Acad Nurse Pract. 2006;18:487–493
  39. Reichenbach S, Sterchi R, Scherer M, et al. Meta-analysis: Chondroitin for osteoarthritis of the knee or hip. Ann Intern Med. 2007;146:580–590
  40. Leeb BF, Schweitzer H, Montag K, Smolen JS. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol. 2000;27:205–211
  41. Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005;CD002946
  42. Konig B. A long-term (two year) clinical trial with S-adenosylmethionine of the treatment of osteoarthritis. Am J Med. 1987;83:89–94
  43. Muller-Fassbender H. Double-blind clinical trial multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of osteoarthritis. Am J Med. 1987;83:1–4
  44. Maccagno A, Di Giorgio EE, Caston OL, Sagasta CL. Double-blinded controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. Am J Med. 1987;83:72–77
  45. Vetter G. Double-blind comparative clinical trial with S-adenosylmethionine and indomethacin in the treatment of osteoarthritis. Am J Med. 1987;83:78–80
  46. Najm WI, Reinsch S, Hoehler F, Tobis JS, Harvey PW. S-adenosylmethionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: A double-blind cross-over trial. BMC Musculoskelet Disord. 2004;5:6
  47. Jacob SW, Herschler R. Dimethyl sulfoxide after twenty years. Ann N Y Acad Sci. 1983;411:13–17
  48. Usha PR, Naida MUR. Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and their combination in osteoarthritis. Clin Drug Invest. 2004;24:353–363
  49. Kim LS, Axelrod LJ, Howard P, Buratovich N, Waters RF. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: A pilot clinical trial. Osteoarthritis Cartilage. 2006;14:286–294
  50. Owens S, Wagner P, Vangsness CT. Recent advances in glucosamine and chondroitin supplementation. J Knee Surg. 2004;17:185–193
  51. Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: A systematic review. JAMA. 2003;289:454–465
  52. Russell AS, Aghazadeh-Habashi A, Jamali F. Active ingredient consistency of commercially available glucosamine sulfate products. J Rheumatol. 2002;29:2407–2409
  53. Joint supplements: Brands to try and brands to avoid. Consumer Reports. June 2006.
  54. Dickinson A. Docket No. 96N-0417, good manufacturing practices for dietary supplements. http://www.crnusa.org/pdfs/CRN_FDA_GMPS081103_Process.pdfAccessed March 2, 2007
  55. Hathcock JN, Shao A. Risk assessment for glucosamine and chondroitin sulfate. Regul Toxicol Pharmacol. 2007;47:78–83

 The authors report no conflict of interest.

PII: S0749-8063(08)00589-6

doi: 10.1016/j.arthro.2008.07.020

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 25, Issue 1 , Pages 86-94 , January 2009

Article Tools