NUTRITIONAL SUPPLEMENTATION FOR KNEE OSTEOARTHRITIS

• Published in: Journal of rehabilitation medicine Vol. 46; no. 10; p. 1065
• Main Authors: Macaluso, Steven, Salter, Katherine, Manocha, Ranita, Batey, Cristina
• Format: Journal Article
• Language: English
• Published: 01.11.2014
• ISSN: 1650-1977

Context: Osteoarthritis (OA) of the knee is a common condition which has considerable impact on patients' quality of life and function. There is increasing interest by patients in the use of nutritional supplements. We looked at the research to see if there is any evidence to help guide use of these supplements for osteoarthritis. Methods: Relevant systematic reviews in English published 2008-2013 were extracted from PubMed, SCOPUS, and Web of Science databases. Articles were assessed for methodological quality using the 11-item AMSTAR system by two independent reviewers. Based on research quality, strength of results and clinical availability, the intervention was then assigned a level of recommendation. Results: Nine systematic reviews met the inclusion criteria and examined various interventions including glucosamine, chondrotin, S-Adenosylmethionine, Dimethyl sulfoxide and methylsulfonylmethane (DMSO/MSM), collagen derivatives, and Avocado-soybean unsaponifiables. Glucosamine alone significantly reduced pain scores, but did not meet clinical significance. No significant differences in pain or function were identified when comparing collagen to placebo. Supplementation with avocado-soybean unsaponifiables significantly reduced pain scores and improved function in one systematic review. Pain was reduced with DMSO/MSM when compared to placebo but this was nullified with a random effects analysis. S-Adenosylmethionine had a non-significant impact on pain or function. Conclusions: There is a wide range in the quality of data for nutritional supplements for knee OA, with most high quality data in favour of glucosamine and avocado-soybean for reduction of pain. Data on collagen derivates, DMSO/MSM and S-Adenosylmethionine comes from poor quality limited evidence.