Purpose
This article discusses current evidence in nutraceuticals and viscosupplementation
uses in osteoarthritis (OA) treatment.
Methods
A search was carried out to identify systematic reviews, randomized controlled trials,
review articles, and original articles (PubMed and Cochrane Database) about nutraceuticals
and viscosupplementation. The keywords used were nutraceuticals, glucosamine, chondroitin,
diacerein, avocado, soybean unsaponifiables, nutraceuticals, and viscosupplementation,
independently or combined with the terms “review” and “randomized.”
Results
Glucosamine hydrochloride has no effect on pain management, although the sulfate formulation
has a moderate effect. Diacerein leads to pain relief, with a superior carryover effect
when compared with placebo. Avocado and soybean unsaponifiables may have positive
effects on knee and hip OA, but long-term results could not be confirmed. Despite
the American Academy of Orthopaedic Surgeons' recommendation against the use of hyaluronic
acid in OA, some systematic reviews found some benefits in the knee.
Conclusions
There is no evidence that nutraceuticals or viscosupplementation influences OA's natural
progression. However, some of these agents seem to reduce pain and improve function.
Level of Evidence
Level IV, systematic review of studies with Level I through Level IV evidence.
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Article info
Publication history
Published online: January 26, 2015
Accepted:
November 13,
2014
Received:
July 12,
2014
Footnotes
See commentary on page 793
The authors report the following potential conflict of interest or source of funding: M.A.P.d.A. receives support from Zimmer (grant CW81571).
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
