Osteoarthritis

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Revision as of 07:30, 16 October 2007 by imported>Robert Badgett
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Signs and symptoms

Osteoarthritis of the knees is associated with buckling, or sudden giving way, of the knees.[1] This is more likely if the quadriceps muscle is weak.

Treatment

Medications

Acetaminophen

A randomized controlled trial comparing acetaminophen to ibuprofen in x-ray proven mild to moderate osteoarthritis of the hip or knee found that equal benefit.[2] However, acetaminophen at a dose of 4 grams per day can increase liver function tests.[3]

Supplements

Chondroitin

A meta-analysis of randomized controlled trials found no benefit from chondroitin.[4]

Glucosamine

A molecule derived from glucosamine is used by the body to make some of the components of cartilage and synovial fluid. Supplemental glucosamine may improve symptoms of OA and delay its progression.[5] However, a large study suggests that glucosamine is not effective in treating OA of the knee.[6] A subsequent meta-analysis that includes this trial concluded that glucosamine hydrochloride is not effective and that the effect of glucosamine sulfate is uncertain.[7]

References

  1. Felson, David T., Jingbo Niu, Christine McClennan, Burton Sack, Piran Aliabadi, David J. Hunter, et al. 2007. Knee Buckling: Prevalence, Risk Factors, and Associated Limitations in Function. Ann Intern Med 147, no. 8 (October 16): 534-540. http://www.annals.org/cgi/content/abstract/147/8/534 (accessed October 16, 2007).
  2. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI (1991). "Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee". N. Engl. J. Med. 325 (2): 87-91. PMID 2052056[e]
  3. Watkins PB, Kaplowitz N, Slattery JT, et al (2006). "Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: a randomized controlled trial". JAMA 296 (1): 87-93. DOI:10.1001/jama.296.1.87. PMID 16820551. Research Blogging.
  4. Reichenbach S, Sterchi R, Scherer M, et al (2007). "Meta-analysis: chondroitin for osteoarthritis of the knee or hip". Ann. Intern. Med. 146 (8): 580-90. PMID 17438317[e]
  5. Poolsup N, Suthisisang C, Channark P, Kittikulsuth W (2005). "Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials". The Annals of pharmacotherapy 39 (6): 1080-7. DOI:10.1345/aph.1E576. PMID 15855241. Research Blogging.
  6. McAlindon T, 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; 117:643-9. PMID 15501201.
  7. Vlad SC, Lavalley MP, McAlindon TE, Felson DT (2007). "Glucosamine for pain in osteoarthritis: Why do trial results differ?" 56 (7): 2267-2277. DOI:10.1002/art.22728. PMID 17599746. Research Blogging.