ObjectiveTo compare the clinical efficacy of glucosamine hydrochloride and diacerein for patients with knee osteoarthritis and the MRI variation. MethodsBetween January and June 2014, 90 patients with knee osteoarthritis were randomized into three groups: group A (treated by glucosamine hydrochloride), group B (treated by diacerein) and group C (treated by both glucosamine hydrochloride and diacerein). The score of Western Ontario and McMaster Universities (WOMAC) index of osteoarthritis, MRI cartilage injury Recht grading and the curative effects for bone marrow edema, joint cavity effusion and meniscus injury were compared before and after the treatment. ResultsThe scores of WOMAC after treatment in all the groups were improved, while the therapeutic effect of group C lasted longer when medical treatment suspended. The number of articular surface with different degrees of cartilage injury showed no statistically significant change in all three groups (P ＞ 0.05) . The state of bone marrow edema and joint cavity effusion were improved with a statistically significant difference in all groups (P ＜ 0.05) . Patients with lateral meniscus degeneration in group A and patients with medial meniscal tear in group B both increased with statistically significant differences (P ＜ 0.05) . However, in group C, patients with lateral meniscus degeneration or meniscal tear decreased with statistically significant differences (P ＜ 0.05) . ConclusionsThe treatment for osteoarthritis by glucosamine hydrochloride is effective, and the curative effect lasts longer when treated by both glucosamine hydrochloride and diacerein. Glucosamine hydrochloride ameliorates the bone marrow edema and joint cavity effusion. Treatment together with diacerein leads to a better therapeutic effect for patients with meniscus degeneration, yet further studies are needed to prove its effects in ameliorating cartilage injury.
ObjectiveTo assess the therapeutic effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride on osteochondritis dissecans of the knee. MethodsBetween January 2014 and June 2015, 24 patients with osteochondritis dissecans of the knee ready to undergo arthroscopic microfracture surgery were divided into experimental group (odd surgery sequence numbers) treated with arthroscopic microfracture surgery combined with oral glucosamine hydrochloride (480 mg/time, 3 times per day, from the first day to 3 months after the surgery) and control group (even surgery sequence numbers) treated with arthroscopic microfracture surgery. All the patients were discharged from the hospital after one week of rehabilitation exercises with rehabilitation equipment of lower extremity. Follow-up lasted for at least 6 months. The therapeutic effects of the two methods were assessed according to Tegner scores for motor function of knee joint and United States New York specialty surgical hospital (HSS) scores. ResultsThe symptoms of knee joint was alleviated significantly after the operation. The function of knee joint was improved significantly after 6 weeks. Tegner and HSS scores before surgery were not significantly different between the two groups (P>0.05). The Tegner scores were not significantly different between the two groups 6 weeks after surgery (P>0.05). The difference of Tegner scores were statistically significant between the two groups 12 and 24 weeks after surgery (P<0.05), and HSS scores of the experimental group improved better than the control group 6, 12 and 24 weeks after surgery, and the differences were statistically significant (P<0.05). ConclusionThe short-term effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride is better than that of arthroscopic microfracture surgery in the treatment of osteochondritis dissecans of the knee.
ObjectiveTo investigate the clinical efficacy of glucosamine hydrochloride tablets in treating knee cartilage injury resulting from rheumatoid arthritis. MethodsWe selected 200 knee cartilage injury patients with rheumatoid arthritis treated in our hospital from January 2011 to January 2015 as the research subjects. They were divided into control group (n=98) and observation group (n=102) according to the time of admission. The control group was treated with conventional disease modifying anti-rheumatic drugs (DMARDs), while the observation group was treated with glucosamine hydrochloride tablets on the basis of DMARDs. The treatment effect was evaluated and compared between the two groups of patients 18, 36 and 54 weeks after the treatment. ResultsFifty-four weeks later, knee pain score of the observation group was better than that of the control group, and the difference was statistically significant (P ＜ 0.05) . The observation group had a lower Noyes evaluation level than the control group, and the difference was statistically significant (P ＜ 0.05) . Adverse reaction in the observation group was 3.92% and it was 3.06% in the control group, and the difference between the two groups was not statistically significant (P ＞ 0.05) . ConclusionGlucosamine hydrochloride tablets combined with conventional anti-rheumatic treatment is effective for knee cartilage injury caused by rheumatoid arthritis, which can promote cartilage repair, and it is worthy of clinical application.
ObjectiveTo observe the efficacy of self-behavior management combined with glucosamine hydrochloride for patients with early knee osteoarthritis. MethodsBetween October 2013 and March 2015, 240 patients with early knee osteoarthritis were randomly assigned to behavior therapy group (n=80) , drug treatment group (n=80) and combined treatment group (n=80) . Patients in the behavior therapy group were treated only by self-behavior management; patients in the drug treatment group were treated by glucosamine hydrochloride (0.48 g, three times per day); patients in the combined treatment group were treated by self-behavior management combined with glucosamine hydrochloride. The effect of treatment, adverse reactions, efficiency and expulsion rate were assessed 4, 8 and 12 weeks after treatment. ResultsThe Lequesne index and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) significantly decreased from week 4 when compared with week 0 after treatment in the combined treatment group, and there was a significant difference between the combined treatment group and single therapy group at week 8 and 12 (P ＜ 0.05) . The Lequesne index in the behavior therapy group and drug treatment group began to significantly decrease from week 8, and the WOMAC score significantly decreased from week 4 in the drug treatment group and from week 8 in the behavior therapy group. The efficiency increased with the treatment time prolonged in all three groups, but the efficiency in the combined treatment group was significantly higher than the single therapy group (P ＜ 0.05) . The shedding rates in the behavior therapy group, drug treatment group and combined treatment group were respectively 12.5%, 7.5% and 6.3%, without statistically significant difference (P ＞ 0.05) . The adverse reaction rate was low in all the three groups. ConclusionThe self-behavior management combined with glucosamine hydrochloride is an effective, safe and well-tolerated treatment for early knee osteoarthritis.
Objective To access the protective effects of glucosamine hydrochloride capsules (OTL) on articular cartilage in osteoarthritis of rabbit. Methods Thirty-six New Zealand white rabbits were divided randomly into three groups (n=12): sham group (group A), anterior cruciate l igament transection (ACLT)/normal sal ine group (group B), and ACLT/ OTL group (group C). Rabbits in groups B, C received ACLT on the right knee. Rabbits in group A were not given ACLT ascontrol. Group C received a daily administration of OTL at a dose of 150 mg/kg of body weight for 12 weeks; in contrast, group B received normal sal ine at the same dose. All rabbits were sacrificed after 12 weeks. The right femoral condyle were removed and observed at pathologic changes with HE staining and graded by Mankin’s scale, the expression level of transforming growth factor β1 (TGF-β1) and interleukin 1β (IL-1β) were detected by immunohistochemical staining. Results All rabbits survived at the end of experiment and incision healed well. The gross observation showed that joint synovia increased and articular surface was smooth and integrity in group A; that ulcer was observed on the articular surface of group B; and that articular surface was smooth and integrity in group C. There were sigificant differences in articular cartilage scores between 3 groups (P lt; 0.05). The histological observation showed that the articular cartilage had normal structure and the cells arranged regularly in group A; that the articular cartilage became thin and the cells arranged irregularly in group B; and that the cells arranged with a clear layer and had regular shape in group C. The Mankin scores were 1.04 ± 0.13, 7.97 ± 0.12, and 2.81 ± 0.36 in groups A, B, and C, respectively; showing significant difference between 3 groups (P lt; 0.05). The result of immunohistochemistry showed that the expressions of TGF-β1 were 50.62 ± 1.51, 24.81 ± 1.28, and 41.57 ± 1.69 and the expressions of IL-1β were 13.12 ± 1.21, 62.53 ±2.37, and 30.67 ± 1.28; showing significant differences between 3 groups (P lt; 0.05). Conclusion A daily administration ofOTL at a dose of 150 mg/kg for 12 weeks can partially decrease the expression levels of IL-1β and increase the expression levels of TGF-β1, which delays the development of osteoarthritis.
ObjectiveTo discuss the effect of glucosamine-hydrochloride (Glu/Ch) in protecting and repairing the cartilage in blood-induced joint damage (BJD) in vivo. MethodsThirty-two adult New Zealand rabbits were randomly divided into 4 groups (n=8):high-dose Glu/Ch treated group (group A), low-dose Glu/Ch treated group (group B), positive control group (group C), and negative control group (group D). A joint bleeding model was established by blood injection into articular cavity in groups A, B, and C. Glu/Ch was given by gavage in groups A (250 mg/kg) and B (21.5 mg/kg) once a day for 8 weeks, and the same dosage of saline was given in groups C and D. The serum cartilage oligomeric matrix protein (COMP), serum chondroitin sulfate 846(CS846), and urinary C-terminal telopepide of type II collagen (CTX-II) were measured at 3 days, 7 days, 2 weeks, and 8 weeks after modeling. The expressions of cytokines such as interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in synovial fluid were analyzed by ELISA at 8 weeks after modeling. The expression of matrix metalloproteinase 13(MMP-13) was detected by immunohistochemistry. Alcian blue staining and Safranin-O staining were performed to calculate the percentage of the positive staining areas. The proteoglycan content was detected by semi-quantitative analysis in the articular cartilage. ResultsThe COMP concentration was significantly higher in groups A, B, and C than group D, and in groups B and C than group A at 3 days after modeling (P<0.05); no significant difference was found among groups A, B, and D at 7 days (P>0.05), and it was significantly lower in groups A, B, and D than group C (P<0.05); there was no significant difference among 4 groups after 2 and 8 weeks (P>0.05). Difference in CS846 concentration had no significance among 4 groups at each time point (P>0.05). The CTX-II concentration of groups A, B, and C was significantly higher than that of group D at each time point (P<0.05); it was significantly lower in group A than groups B and C at 7 days, 2 weeks, and 8 weeks (P<0.05). The TNF-α concentration of groups A and B was significantly higher than group D, and was significantly lower than group C at 8 weeks (P<0.05), but no significant difference was observed between groups A and B (P>0.05). The IL-1β concentration was significantly higher in group C than the other groups (P<0.05), and in group B than groups A and D (P<0.05), but there was no significant difference between groups A and D (P>0.05). The MMP-13 expression was significantly higher in group C than groups A, B, and D (P<0.05), in groups A and B than group D (P<0.05). A significant decrease in the area stained with Alcian blue and Safranin-O was observed in group C. There were significant differences in the percentage of the positive stained areas of Alcian blue and Safranin-O among 4 groups (P<0.05). The relative quantities of proteoglycan from small to large in order was groups C, B, A, and D, respectively, showing significant differences (P<0.05). ConclusionThe metabolism disorder of cartilage matrix and synovium inflammatory reaction can be observed in rat joint bleeding model. Glu/Ch has certain protective effect on the cartilage after BJD by down-regulating IL-1β, TNF-α, and MMP-13, as well as increasing proteoglycan content in the cartilage.
ObjectiveTo evaluate the efficacy of the glucosamine hydrochloride combined with risedronate in the treatment of knee osteoarthritis (KOA) associated with cold pain of knee. MethodsThe clinical data of 50 KOA patients including 25 with cold pain and 25 without cold pain, treated in the Department of Rheumatology between January and December 2015 were collected. The clinical symptoms, Western Ontario and McMater Universities (WOMAC) index of osteoarthritis score, knee cold pain score, knee joint therml texture maps (TTM) score, serum osteoprotegerin (OPG), Dickkopf-1 (DKK-1) , and sclerostin levels (SO) were recorded for comparison between patients with and without cold pain in order to investigate the correlation between these indicators and cold pain degree. Patients in the cold pain group were treated with glucosamine hydrochloride combined with risedronate. Follow-up lasted for six months, and the improvement of above indexes and the treatment safety were analyzed. ResultsThere were significant differences between the two groups in the disease course, TTM score of knee front and popliteal fossa, ΔTTM, DKK-1 and SO (P ＜ 0.05) . After 6 months of treatment, patients in the cold pain group improved significantly in WOMAC score, knee cold pain score, TTM score of knee front and popliteal fossa, ΔTTM, OPG, DKK-1 and SO (P ＜ 0.05) . ConclusionsAs one of the main complaints of patients with advanced OA, knee cold pain is associated with the metabolic activity of osteoclasts. It can be alleviated by the treatment with risedronate combined with glucosamine.
ObjectiveTo investigate the effect of arthroscopic debridement combined with oral glucosamine hydrochloride tablets in the treatment of knee osteoarthritis. MethodsSixty-two patients with knee osteoarthritis treated between January 2013 and April 2015 were chosen to be our research subjects. They were randomly divided into trial group (n=31) and control group (n=31). The control group was treated with arthroscopic debridement, and the trial group was given glucosamine hydrochloride tablets for treatment, apart from arthroscopic debridement. We evaluated the clinical effects by visual analogue scale (VAS) score and Lysholm knee joint function score before, and 1 week, 4 weeks, 3 months and 6 months after surgery. ResultsOne week after surgery, the VAS score and Lysholm knee joint function score were not significantly different between the two groups (P>0.05). Four weeks, 3 months and 6 months after surgery, the VAS score of the trial group was respectively 3.08±0.91, 2.46±0.87, and 1.45±0.66, and was 5.47±1.02, 3.55±1.20, and 2.37±0.53 in the control group; the Lysholm score of the trial group was 80.55±2.24, 85.35±1.79, and 89.74±4.58, respectively, and of the control group was 72.55±4.47, 74.68±2.94, and 76.69±5.63. The VAS score and the Lysholm score of the trial group were both better than those of the control group (P<0.05). ConclusionArthroscopic debridement can alleviate the symptoms of knee osteoarthritis, and oral administration of glucosamine hydrochloride tablets after surgery has obvious effects.
ObjectiveTo study the effectiveness and safety of glucosamine for osteoarthritis (OA) in Asian population. MethodDatabases of PubMed, Embase, CNKI, VIP and Wanfang were searched from the time of establishment till May 2014 and controlled trials of glucosamine compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) were included. Quality evaluation and Meta-analysis by using RevMan 5.1 were performed. ResultsA total of 17 studies including 2 251 cases were included. The efficiency rate in the glucosamine group was higher than that in the NSAIDs group[OR=3.03, 95% CI (1.78, 5.18), P<0.000 1]. The efficiency rate in the glucosamine combined NSAIDs group was higher than that in the NSAIDs group[OR=4.30,95%CI (1.84,10.06),P=0.000 8]. The safety analysis showed that the adverse event rate in the glucosamine group was lower than that in the NSAIDs group[OR=0.23,95%CI (0.14,0.37),P<0.000 01], while the difference between the glucosamine combined NSAIDs group and the NSAIDs group was not statistically significant[OR=0.84, 95%CI (0.50, 1.41), P=0.50]. ConclusionsCompared with NSAIDs, glucosamine is better and safer for OA treatment in Asian population.
Objective To observe the treatment efficacy and safety of glucosamine hydrochloride tablets on uremia patients with knee osteoarthritis (OA). Methods A total of 118 uremia patients with knee OA were selected and randomly divided into the glucosamine hydrochloride tablets treatment group (treatment group) and the coated aldehyde oxystarch capsules group (control group) with 59 cases in each group. The course was 8 weeks. The Lequesne Index was assessed for curative effect evaluation, and the change of blood indexes was observed to evaluate drug safety. Results The total effective rate of Lequesne Index in the treatment group was 72.9%, while that in the control group was 13.6%; the difference was statistically significant (χ2=42.303, P<0.001). There was no significant change in the two groups before and after treatment in terms of the patients’ dialysis adequacy, routine blood, blood electrolytes, liver and kidney function (P>0.05). Conclusion Glucosamine hydrochloride tablets is curative and safe in the treatment of uremia patients with OA.