Osteoarthritis

Q:  I’ve been reading about a new approach for osteoarthritis sufferers. It is called glucosamine sulfate and is supposed to be a natural chemical to help build cartilage. What is your opinion on this new research? Is it safe? Mary, West Allis.

A:  I appreciate the specific nature of your question and your use of the term osteoarthritis. This type of arthritis is most common in the elderly and also associated with overuse of a particular joint. The primary problem is a wearing away of the cartilage that covers the joint surfaces that rub against one another. The main purpose of the cartilage is the provision of a smooth surface allowing free and painless movement. Absence or loss of the cartilage drastically increases the friction generated with movements and is the major source of the pain and aching associated with osteoarthritis.

The restoration of cartilage would be a dramatic breakthrough in the treatment of osteoarthritis. The chemical you mention is one of a class of chemicals known as proteoglycans. Ann Rosenthal M.D., assistant professor in the Department of Rheumatology at MCW is aware of some European studies involving the injection of these substances directly into one’s affected joints, where there may be a resultant increase in the viscosity or thickness of existing joint fluid, providing better lubrication. The data to support this are minimal and have not resulted in the application of this technique in the United States. She did clearly state that if these chemicals are taken orally, they are passed through one’s digestive system and are useless for the treatment of osteoarthritis.

I did do some additional research and confirmed that there are two companies in California that are using genetic research to clone human cartilage. This new cartilage is then injected into the affected joints in the hope that it will "take root" and restore and repair damaged joint surfaces. As of yet there are no long-term studies demonstrating the usefulness of such a technique and no widespread availability.

Some of the most important steps one can take to maximize function and decrease pain include: aggressive weight loss to reduce joint loading, exercises to improve or preserve motion, the avoidance or diminution of repetitive activities involving the most affected joints (perhaps switch from jogging to swimming or bicycling), and the use of splints and other orthotic devices.

Dr. Russell Robertson is Associate Dean for Faculty Affairs and Associate Professor of Family and Community Medicine at the Medical College of Wisconsin. His biweekly column of medical advice also appears in the CNI Community Newspapers throughout metropolitan Milwaukee.