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Goal of osteoarthritis (OA) treatment is to relieve the pain and to reduce the loss of patient's physical functionality. Therapy consists of: nonpharmacological measures, pharmacotherapy and surgery. Although nonpharmacological approach represents a basis of OA treatment, pharmacotherapy is an important adjunct. Medications that are used in this disease can be administered orally, topically or intra-articularly. In OA treatment the following medications are used: analgesics, glucosamine- and chondroitin-based preparations, glucocorticoids and hyaluronic acid (intra-articular administration) and other medications. Nonopioid analgesics represent a corner stone in OA pharmacotherapy. Treatment initiation with paracetamol (acetaminophen) and/or topical nonsteroidal anti-inflammatory drug (NSAID) is recommended. Afterwards, in a case of complete or partial treatment failure, oral traditional NSAID (tNSAID) or selective COX-2 inhibitor should be used, or opioids as a substitute or an adjunct. Glucosamine- and chondroitin-based preparations are not recommended for OA treatment. Intra-articular use of glucocorticoid (triamcinolon) can lead to short lasting removal of pain and inflammation, while intra-articular use of hyaluronic acid is not recommended. Surgical treatment is important for heavy joint damage and in the case of failure of other treatment modalities. Cilj lečenja osteoartritisa (OA) je ublažiti bol i smanjiti gubitak fizičke funkcionalnosti pacijenta. Terapija se sastoji od: nefarmakoloških mera, farmakoterapije i hirurgije. Mada nefarmakološki pristup predstavlja osnovu lečenja OA, farmakoterapija je važan dodatak lečenju. Lekovi koji se primenjuju u ovoj bolesti mogu se davati per os, topikalno ili intraartikularno. U lečenju OA koriste se sledeći lekovi: analgetici, preparati na bazi glukozamina i hondroitina, glukokortikoidi i hijaluronska kiselina (intraartikularna primena) i ostali lekovi. Kamen temeljac u farmakoterapiji OA čine neopioidni analgetici. Preporučuje se otpočinjanje terapije paracetamolom i/ili topikalnim nesteroidnim antiinflamatornim lekom (NSAIL), nakon čega u slučaju potpunog ili delimičnog neuspeha treba primeniti oralne tradicionalne NSAIL/selektivne inhibitore ciklooksigenaze 2, ili opioide kao zamenu ili dodatak terapiji. Preparati na bazi glukozamina i hondroitina se ne preporučuju za lečenje OA. Intraartikularna primena glukokortikoida (triamcinolon) može da dovede do kratkotrajnog otklanjanja bola i inflamacije, dok se intraartikularna primena hijaluronske kiseline ne preporučuje. Hirurško lečenje je važno kod teških oštećenja zglobova u OA i neuspeha ostalih oblika lečenja.

Optimally balanced diet in order to body weight control in combination with adequate physical activity has an important role in the prevention of degenerative joint disorders. Weight reduction is important in ameliorating some of the manifestations of osteoarthritis (OA) and improving the quality of life. There is growing interest in the beneficial effects of some nutrients, especially polyunsaturated fatty acids and vitamin D, as well as many non-nutrient biological active compounds on progression structural damages, pain and functions of the joints. Glucosamine, chondroitin sulfate, S-adenosylmethionine, methylsulfonylmethane, alone or in combination, are among the most widely used dietary supplements for the prevention and treatment of OA. However, there are limited high-quality designed clinical trials which supported its potential symptomatic and structure-modifying effects. Optimalna ishrana u cilju održavanja idealne telesne mase uz odgovarajuću fizičku aktivnost ima značajnu ulogu u prevenciji degenerativnih oboljenja zglobova. Klinička ispitivanja su pokazala da gubitak povećane telesne mase smanjuje simptome i poboljšava kvalitet života pacijenata sa osteoartritisom (OA). Takođe, sve je veće interesovanje o uticaju pojedinih nutrijenata, posebno polinezasićenih masnih kiselina i vitamina D, kao i brojnih nenutritivnih biološki aktivnih sastojaka, na strukturna i funkcionalna oštećenja zglobova, kao i kontrolu bola kod OA. Najčešći sastojci dijetetskih suplemenata sa potencijalnim hondroprotektivnim delovanjem su: glukozamin, hondroitin-sulfat, S-adenozilmetionin, metilsulfonilmetan i dr, pojedinačno ili u kombinaciji. Međutim, ograničeni broj adekvatno dizajniranih randomizovanih kontrolisanih ispitivanja potvrdio je njihove simptomatske i strukturno modifikujuće efekte.

WOS: 000315847100002 PubMed ID: 23588972 BACKGROUND The aim of this study is to determine whether glucosamine-sulfate has any effects on bone-healing. METHODS A unilateral fracture was created in the tibia of sixty-one female rats. Rats were given no drug or 230 mg/kg glucosamine- sulfate daily. Fractures were analyzed during the first, second and fourth weeks after creation of fracture. Quantitative measurement for new bone formation and osteoblast lining were determined histologically. Semiquantitative score for fracture healing was used for histomorphometric analyses. Bridging bone formation was assessed radiographically. RESULTS New bone formation and osteoblast lining were significantly higher in glucosamine-treated group at week 1. Surrounding connective tissue was more cellular and vascular, and the newly formed bone trabecules were present in greater amounts in glucosamine-treated group, compared to control group at week 1 and 4. But radiologically, the control group had better scores than that of the glucosamine- treated group at week 4. CONCLUSION These data demonstrate that daily glucosamine-sulfate administration accelerates early phase of fracture repair in the rat tibia, with increased new bone formation and osteoblast lining histologically, but radiologic bone union is not favored on radiographs. Bu çalışmanın amacı kıkırdak glukozaminin kırık iyileşmesi üzerinde etkisi olup olmadığının araştırılmasıdır. GEREÇ VE YÖNTEM Altmış bir dişi şıçan tibiasında tek taraflı kırık oluşturuldu. Sıçanlara ya 230 mg/kg glukozamin sülfat verildi ya da ilaç verilmedi. Kırıklar, kırık oluşumundan sonra birinci, ikinci ve dördüncü haftalarda incelendi. Yeni kemik oluşum miktarı ve osteoblast sayısı histolojik olarak ölçüldü. Histomorfometrik analiz için kırık iyileşmesi semikantitatif olarak skorlandı. Radyografik olarak kemik köprü oluşumu değerlendirildi. BULGULAR Glukozamin verilen grupta yeni kemik oluşumu ve osteoblast sayısı 1. haftada anlamlı derecede yüksekti. 1. ve 4. haftalarda kontrol grubuna göre, glukozamin verilen grupta çevre bağ dokusu hücre sayısı bakımından zengin, daha vasküler ve yeni oluşan kemik trabekülleri daha fazla sayıdaydı. Fakat radyolojik olarak 4. haftada kontrol grubu, glukozamin verilen gruptan daha iyi skorlar aldı. SONUÇ Bu veriler günlük glukozamin verilmesinin sıçan tibiasında kırık iyileşmesinin erken fazını, artmış yeni kemik oluşumu ve osteoblast sayısı ile histolojik olarak hızlandırdığı, fakat radyolojik olarak aynı etkinin görülmediğini göstermektedir