The Bristol Knee Clinic
David Johnson in theatre and with a patient

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The Bristol Knee Clinic

The Bristol Orthopaedic Clinic

• The Glen Spire Hospital, Bristol
• St Mary's Hospital, Bristol
• St Joseph's Hospital, Newport
• The Lister Hospital, London

Appointment Bookings:

• Tel: 0117 970 6655

Address:


The "Glen" Spire Hospital
Redland Hill
Bristol BS6 6UT

Tel: 0117 980 4080


Bristol Nuffield Hospital at St Mary's
Upper Byron Place
Bristol BS8 1JU

Tel: 0117 970 6655



St Joseph's Hospital
Harding Avenue
Malpas
Newport NP20 6ZE

Tel: 01633 820300


The Lister Hospital
The Lister Hospital
Chelsea Bridge Rd.
Chelsea
London
SW1W 8RH

Tel: 01179 706655

Glucosamine and Chondroitin


Glucosamine and Chondroitin

Glucosamine and Chondroitin have been shown to have some beneficial effects on osteoarthritic joints, and so may be worth trying if you have this kind of joint problem.

Osteoarthritis (OA) is the most widespread type of arthritis, a degenerative condition of the joints. Acute inflammation is uncommon in OA and it is mostly a "wear-and-tear" disease involving degeneration of joint cartilage and the formation of bony spurs in various joints.

Joint trauma, repetitive joint stresses in jobs, and obesity are risk factors. OA is very common over 60 years of age, but not always troublesome.

You will have seen advertising and promotion of Glucosamine and Chondroitin as a treatment for OA.

What are these substances?

Glucosamine, an amino sugar, is a natural substance made by your body, an essential building block of joint cartilage, ligaments, bones and blood vessels, and is thought to promote the formation and repair of cartilage.

Chondroitin, a carbohydrate, is a natural cartilage component linked to levels of water retention and elasticity and to the inhibition of enzymes that break down cartilage. Both compounds are manufactured by the body.

You can buy both these dietary supplements as tablets from your local health food shop or chemist and they are often taken together.

Research

Glucosamine may stimulate the production of cartilage-building proteins and Chondroitin may inhibit the production of cartilage-destroying enzymes and fight inflammation. The shells of shellfish are the source of Glucosamine, while Chondroitin supplements are extracted from the cartilage of cows.

Studies on people have shown that both may relieve arthritic pain and stiffness with fewer side effects than conventional arthritis drugs. However, there is no evidence to suggest that they are as effective as conventional drug therapies. The manufacture and distribution of these drugs is not restricted or regulated in the same exacting way conventional drugs are. The nature of the active ingredient and effectiveness or indeed concentration of the active compound in each of the available products varies widely.

We don't really know as there isn't any convincing evidence that Glucosamine or Chondroitin help to ease the symptoms of osteoarthritis. There is some weak evidence that Glucosamine, or a combination of Glucosamine and Chondroitin, might be helpful and no evidence that taking Chondroitin on its own is helpful. Glucosamine may help by reducing pain and stiffness rather like a non steroidal anti-inflammatory drug (NSAID). Some trials have shown that Glucosamine, or Glucosamine plus Chondroitin, can help to control the symptoms of osteoarthritis. However, these trials have faults in them which make the results unreliable. So it is difficult to be sure whether these treatments work or not.

Products

In the US, Glucosamine and Chondroitin products are marketed as "dietary supplements". Glucosamine is available in many forms, including Glucosamine sulphate, Glucosamine hydrochloride (HCl), and N-acetylglucosamine (NAG), and have various other contents. However, there appears to be no conclusive evidence that one form is better than another.

Safety

No serious side effects from either Glucosamine or Chondroitin have been found in the trials to date.

Links

Go to Best Treatments and Clinical Evidence and put "Glucosamine" or "Chondroitin" into the search boxes. Both these useful sites give reference lists to the medical evidence.

ConsumerLab is a very useful site, with analysis of all the evidence and also of the products. Some products don't have any of the substance in them that they claim to have!

If you'd like to think about the issues and make an informed decision, the US Food and Drug Administration Centre for Food Safety and Applied Nutrition has issued a document Tips for the Savvy Supplement User: Making Informed Decisions And Evaluating Information which may be of interest.


Useful links

Arthritis Care

Complementary Medicine Association

National Ankylosing Spondylitis Society
Ankylosing Spondylitis is one of the commonest arthritic diseases, especially amongst young men. Although not usually severely disabling, it can have a big effect on a person's life.

National Osteoporosis Society

Arthritis Research Campaign
The ARC is the fourth largest medical charity in the UK and had an annual income of 26m in 2001-2. It funds research into all the different kinds of arthritis and provides information for professionals and the public.

Arthritis Resources - Comprehensive information
A comprehensive site devoted to arthritis and degenerative joint disease.

www.allaboutarthritis.com

www.orthogate.org/patient-education/knee/viscosupplementation-for-osteoarthritis-of-the-knee.html

www.hss.edu


How to make an appointment

Contact us directly:
Andrea Beaumont An appointment may be booked directly through Mrs Andrea Beaumont, Personal Assistant to Mr David P Johnson, by telephoning (44) 0117 970 6655 or via our
e-mail contact form.

Appointments by referral::
Where a referral is from your GP or physiotherapist a letter will usually be provided including the details of any previous treatment received or other relevant medical details.

Useful information to bring to your appointment:
It is helpful if any previous X-rays or scans which are available are brought to the consultation, and the general practitioner may wish to provide the details of previous treatment received and other medical conditions.


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