The medical journal, American Family Physician, recently published an article in which they review the relevant research to identify which supplements may actually provide improvements in arthritis.

The reviewer’s to pick is glucosamine sulfate. There have been numerous studies on glucosamine. The authors, researchers at Creighton University in Omaha, state that more that 20 randomized studies involving more than 2,500 patients have been conducted.

As I have written in other postings, the efficacy of glucosamine can still be a controversial subject. This report indicates that the results may appear to be contradictory as a result of the variety of glucosamine formulations and the study methods. They state that studies that utilize glucosamine sulfate specifically provided consistent benefits for arthritis patients.

Another popular supplement is chondroitin. Prior studies for this supplement also show inconsistent results. Chondroitin is commonly sold in combination with glucosamine. The reviewers at American Family Physician found little evidence that chondroitin in combination with glucosamine is more effective than glucosamine sulfate alone.

The reviewers also identify a promising supplement called SAM-e, which stands for S-adenosylmethionine. A recent study compared SAM-e with the anti-inflammatory drug Celebrex. According to the study, Celebrex users experienced more relief after 1 month of treatment, but after 2 months there was no difference.

SAM-e also appears to have fewer gastrointestinal effects than most anti-inflammatory drugs. But it does have potential side effects, such as headache and insomnia. It also has the potential to interact with antidepressants and other drugs.

The report also covers the research on MSM, devil’s claw, turmeric and ginger, but concludes there isn’t enough evidence to support their use.

You can read the report here.

Originally posted 2008-03-14 23:07:38. Republished by Blog Post Promoter

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222 people were involved in the study conducted by Dr. Rianne M. Rozendaal at the Erasmus Medical Center in Rotterdam, the Netherlands. Half of them were randomly assigned 1,500 mg glucosamine daily in the form of a glucosamine sulfate supplement, while the other half received a placebo. Physicians, patients and researchers were blinded to the group assignmtents.

The study participants had relatively early stage hip osteoarthritis, half of them for 3 years or less. In order to enhance the validity of the study, researchers required the glucosamine supplier to double-check that the tablets had the correct dosage. 93% of the subjects completed the entire study.

Pain and function levels were measured prior to the start of the study, every 3 months during the study and at the end. X-rays of the affected joints were taken at the beginning and end.

The researchers found that there was no significant effect on pain or function based on the Western Ontario and McMaster Universities (WOMAC) pain and function subscales, nor in stiffness, use of pain medication or progression of the disease. In addition, 15 of the study participants underwent hip replacement surgery which may have impacted the analysis.

Some researchers are calling for additional studies focused on individuals with more advanced arthritis, saying this study’s participants had little room for improvement due to the early stage of the disease.

A commentary published with the study called into question the efficacy of the glucosamine as a result of non-standardized glucosamine preparations.

The study was published in the February issue of the Annals of Internal Medicine.

Originally posted 2008-02-25 19:46:46. Republished by Blog Post Promoter

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Much research points to unusually high loading of the knees (high amounts of stress on part or all of the knee joint) as a significant factor in risk of injury and OA disease progression.

In this investigation, presented at the American College of Rheumatology Annual Scientific Meeting in Boston, the team studied 13 women and 3 men with knee OA. They evaluated the participants gait (evaluation of the way they walk and the load on their knees) while barefoot and wearing several different types of shoes. The shoes included clogs, a stability shoe (designed to limit fool movement), a flat, flexible shoe (designed to allow significant foot movement), and flip-flops.

The participants were given time to adjust to each type of footwear before the knee load analysis, based on walking at normal speed, was completed.

The researchers found that the stability shoes and clogs resulted in significantly higher loading of the knees. They also found that walking shoes and flip-flops resulted in lower loads that were similar to walking barefoot.

According to Najia Shakoor, MD, assistant professor of internal medicine, Section of Rheumatology, Rush Medical College, and an investigator in the study: “These results highlight the importance of re-evaluating the design of modern day shoes in terms of their effects on knee loads and knee OA”.

“Knee loads play an important role in the progression of knee osteoarthritis. Shoes have traditionally been engineered to provide foot comfort and little previous attention has been directed to the effects that shoes may have on loading of osteoarthritic knees.”

An earlier study, published in the September, 2006 issue of Arthritis & Rheumatism, also found that walking barefoot provided lower loading on the knees than walking shoes.

In that study, 75 participants with knee osteoarthritis underwent gait analysis while walking barefoot and in their walking shoes.

Walking barefoot reduced the loads on the knee by 11.9%. Additionally, significant reduction was also found in the hips, as well as reductions in hip rotation.

These researchers also concluded that shoes may increase knee loads and increase risk of joint damage on the lower extremity joints in patients with knee osteoarthritis.

An even earlier study from 2003, conducted by Dr. D. Casey Kerrigan, chair of the University of Virginia Department of Physical Medicine and Rehabilitation also found a link between shoes and OA disease progression. Her research suggested that high-heel shoes may be a primary reason why osteoarthritis is twice as common in women as in men.

Her research found that walking in 2 inch, narrow-heeled shoes increases the strain on the parts of the knee most vulnerable to osteoarthritis by 23% compared to walking barefoot. And surprisingly, wide-heeled shoes increased the loads by an even greater 30%.

Originally posted 2008-03-17 19:13:50. Republished by Blog Post Promoter

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Researchers at the University of Melbourne, led by Dr. Rana S. Hinman, performed 3-dimensional (3D) gait analysis of 40 volunteers. The 16 men and 24 women all met the criteria for knee OA and had symptoms such as persistent knee pain and loss of physical function. The participants averaged 65 years of age and none had undergone a joint replacement.

The 3D analysis of each volunteer was performed on the most affected knee using a Vicon 6-camera motion analysis system. In addition, force plates were embedded in the walkway to measure ground impact and reflective markers were placed on the pelvis, thigh, knee joint and foot to record limb movement.

Each participant was tested in bare feet, followed by testing in their own shoes. Further, 20 of the volunteers were tested in their own walking shoes and using a cane in the hand opposite of the knee being measured. They were given instruction in ideal cane use by a trained physiotherapist.

5 trials were conducted to calculate changes in gait parameters and the load on the knee.

Most of the participants experienced increased load on the knee (more than 7% higher) while wearing shoes over walking barefoot. Using a cane reduced the load by an average 10%, a benefit the researchers considered to be significant. A quarter of the volunteers experienced a load reduction of over 20%.

“Further studies are required to establish whether knee loading remains lower with ongoing use of a cane,” notes Dr. Hinman, “and whether the reductions in loading translate to a reduced risk of disease progression.”

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#6: Development of a woven mesh for cartilage engineering

Researchers have been looking for a way to create cartilage that can be used to replace cartilage that has been damaged by arthritis. Biomedical engineers have been able to create simple cartilage but continue to work on development of cartilage that demonstrates the same biologic and mechanical properties as natural cartilage.

In 2007 Duke University Medical Center’s Farshid Guilak, PhD, along with a team from Duke and the Massachusetts Institute of Technology achieved a breakthrough in the development of biologic cartilage.

The team produced an innovative structure on which to grow cartilage. It is based on a microscopic technology that creates a 3 dimensional scaffold which can be seeded with cartilage cells. This “textile” is a weave of fibers in 3 directions giving it length, width and depth.

The cell-infused fabric is then transplanted into the arthritis damaged joint. Over time the cells will grow and mature into healthy cartilage while the scaffold breaks down and is absorbed by the body.

Next for the team is to test the engineered tissue on mice to validate that the new cartilage functions correctly. If that is successful, this new form of cartilage will be available to treat joints damaged by osteoarthritis or other cartilage injuries.

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