Animation by Craig Wiesenhutter, MD

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JOINTS
Synovial Joint Knee Joint Anatomy Vertebral Joint
Anatomy

• Animation by Craig Wiesenhutter, MD
• www.cdaarthritis.com/images_slides
• http//cwcdaart.securesites.net/

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Proteoglycan or aggrecan. Key component of the
ground substance of cartilage. Made of proteins
and glycosaminoglycans (chondroitin sulfate,
keratan sulfate). Marieb Hoehn 4.7.
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Protein core
Craig W. Wiesenhutter www.cdaarthritis.com/images_
slides
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Two popular treatments for osteoarthritis are
sold as dietary supplements (therefore proof of
efficacy or content of the supplement is not
required) chondroitin and glucosamine.
Chondroitin is a glycosaminoglycan, a large,
hydrophilic, gel-forming polysaccharide which
gives cartilage much of its ability to withstand
compression. Glucosamine is a component of
chondroitin.
Glucosamine www.genome.jp/Fig/compound/C00043.gif
Chondroitin one subunit portion derived from
glucosamine highlighted www.genome.jp/Fig/compoun
d/C00607.gif
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The best current evidence is that chondroitin
sulfate does not reduce joint pain in
osteoarthritis. However, some patients are
convinced that it helps, which could be because
of a placebo response or even a therapeutic
response resulting from enhanced absorption or
limited metabolism of chondroitin. Because no
frequent or severe adverse effects have been
reported, chondroitin sulfate should not be
considered dangerous. If patients say that they
benefit from chondroitin, I see no harm in
encouraging them to continue taking it as long as
they perceive a benefit.D. Felson, MD, MPH Ann
Intern Med. (2007) 146 611-612.
Chondroitin www.3dchem.com/imagesofmolecules/Chond
roitin.jpg
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Glucosamine sulfate is no better than placebo in
reducing the symptoms or progression of hip OA,
according to a randomized, double-blind,
placebo-controlled trial in the Netherlands
(2008). 222 patients were treated for two years
with glucosamine sulfate or placebo. Primary
outcome measures were hip pain, hip function, and
joint space (assessed radiographically, i.e. by
X-ray images). (Joint space decreases as OA
progresses.) Glucosamine sulfate was no better
than placebo for any of the main outcome
measures. Ann Intern Med. (2008) 148 268-277.