Large scale, independent studies of glucosamine and/or chondroitin have not shown a definitive benefit for the treatment of painful knee osteoarthritis (OA) and the effect of retarding knee OA progression remains controversial. Despite this, the use of glucosamine as a complementary/alternative medicine is widespread, amounting to a multi-million dollar industry. Many users take glucosamine for OA at sites other than the knee, sites which have received little to no study of efficacy.
Knee pain from osteoarthritis (OA) tends to be poorly correlated to degree of cartilage loss. Other factors related to knee OA, including bone marrow edema and synovitis, may be more proximal determinants of pain in knee OA. Synovitis is usually quite limited in knee OA and difficult to quantify on physical exam. Magnetic resonance (MR) imaging is a more sensitive technique for assessing synovitis in knee OA.
Pain perception in osteoarthritis (OA) is complex, with the intensity of pain reported in affected individuals often with little correlation to structural damage. Few studies have explored the neural networks responsible for processing pain in OA.
Exercise may decrease the risk of developing knee osteoarthritis (OA) via trophic effects on cartilage and muscle strengthening. However, exercise may also predispose to knee OA via joint loading and the potential for traumatic injury. These predisposing factors may be more important in individuals who are overweight or obese.
Despite its prevalence, no effective pharmacotherapies have been definitively proven to modify the course of radiographic knee osteoarthritis (OA). Risedronate, a bisphosphonate that reduces bone turnover, has been shown in animal models to inhibit cartilage degradation and progression of disease.
Mechanical forces exerted on the knee contribute to the development of knee osteoarthritis (OA). Among these, the additional torque about the knee associated with increasing leg length may predispose people of taller stature to knee OA. However, this association has received little prior investigation. In contrast to body height, which may decrease with age, knee height is relatively constant, making knee height a more appropriate surrogate for stature in the elderly.
