Under the knife or popping pills? No, neither/ |

Playing tennis and basketball as we age, trying to stay active and not succumb to becoming a couch potato has its benefits. And, it’s pains. No, not a pain in the …, but one in the knees.

And, given the BS that flows across the internet, it should not be surprising that so many folks spend tons of money on supplements to “solve their problems”. But, it turns out chondroitin and glucosamine have only one great benefit- the profits they accrue to their vendors.

I’m not even talking about the fact that many of these supplements don’t contain what they promise. (Finally, some Attorneys General are prosecuting vendors of these adulterated products.)

No, I’m talking about the “benefits” of taking the chondroitin or glucosamine at all. Oh, and for all your folks who bitch and moan about big pharma adjusting reporting results- keep in mind that the following results were from a study funded by GlaxoSmithKline (GSK), Novartis, Merck, and Pfizer.

Drs. S. Yang (VCU, Richmond), C. Eaton (Brown and Pawtucket Memorial Hospital), T. McAlindon (Tufts, Boston), and K. Lapane (UMass, Worcester) analyzed the data from 1625 patients participating in the Osteoarthritis Initiative (OAI). These folks all manifested osteoarthritis in at least one knee who had never take chondroitin or glucosamine until the study onset and had annual xrays to assess the status of their knee joint(s).

The results were just published in the journal, Arthritis and Rheumatology. Of the study participants, about 18% took chondroitin and/or glucosamine (most took both). But, comparing those groups taking the drug(s) at least 4 days a week and those never taking any drug, there was no effect on the symptoms or progression of the disease. (That means no joint improvement, no reduction in pain, no change in stiffness or function.)

It gets even more interesting. For those who develop (or create) tears in the meniscus (the crescent shaped piece of cartilage in the knee; the “shock absorber” between the upper and lower knee joints), there may not even be a need for knee surgery.

I know there are some 700K folks getting this surgery done each year. And, it shouldn’t surprise anyone that there is no set cost (or fee) for this operation. Knee replacement ranges from $16,772 and $61,585, quite a wide range. (You do know that in healthcare there is little correlation between price and best outcomes, right?)

(By the way, physicians are turning to 3D printers to prepare custom made replacement menisci. Conformis, a Massachusetts firm, has made it possible to made a new mensicus that is a perfect fit for each patient. So, instead of guessing on the size and then “chiseling” around to make the fit, this new process relies on a CT scan of the knee in question and then have the device prepare the new part to match- perfectly.)

Drs. R. Sihvonen, M, Paavola, A. Maimivaara, A. Joukainen, H. Nurmi, J. Kalske, and T. Jarvinen compared surgery versus no surgery for some 146 patients ranging in age from 35 to 65. Now, actually, “no surgery” still meant they put the patients under (general or local anaesthesia) and “made believe” they operated. Otherwise, the patient would know nothing happened.

So, all patients were subjected to two incisions. And, that is why the study was not performed in the US- because it is against our regulations to subject a patient to an incision without any purpose. But, the results from Finland should be perfectly clear- and adaptable to any population- except for the fact that only about 150 patients were included in the study.

Those who underwent the true surgery did manifest a decrease in pain after exercise for the first few months. But, by the time a year had elapsed, there was no difference in pain or quality of life measures between the two populations.

It also must be recognized that those participating in the study all developed their knee problems over time- they were not subject to a specific traumatic event (e.g., sports injury).

Caveat emptor!