Abstract

Chondroitin sulfate (CS) is a major component of the extracellular matrix of many connective tissues, including cartilage, bone, skin, ligaments, and tendons. The aim of this work was to study the effect of CS treatment for short time (6 months) clinically and using MRI on cartilage volume loss, subchondral bone marrow lesions (BMLs), and synovitis in patients with primary knee osteoarthritis (OA). A total of 50 patients with primary knee OA and clinical signs of synovitis were included in this study. They were divided into two treatment groups. Group 1 included 30 patients who received two capsules of CS (structum capsule 500 mg) once daily for 6 months. Group 2 included 20 patients who received placebo once daily for 6 months. Clinical, radiological, and laboratory assessments were performed for all patients. Cartilage volume loss, subchondral BMLs, and synovial membrane thickness were assessed with MRI at baseline and after 6 months for both groups. The CS group showed significantly less cartilage volume loss compared with the placebo group after 6 months for the global knee, lateral compartment and tibial plateaus. However, there were no significant differences in the medial compartment and trochlea between the two groups. Significantly lower BML scores were found for the CS group compared with theplacebo group after 6 months, and there were no significant differences in synovial membrane thickness between the two groups. Disease symptoms were similar in both groups. CS treatment significantly reduces the cartilage volume loss and subchondral BMLs in primary knee OA after 6 months of treatment. These findings suggested a joint structure-protective effect of CS.

Highlights

  • Of all the musculoskeletal conditions, osteoarthritis (OA) has the highest prevalence, affecting a significant percentage of the aging population [1]

  • Our data revealed that patients in the Chondroitin sulfate (CS) group, compared with those in the placebo group, experienced a significant reduction in cartilage volume loss in the global knee after 6 months (Figs 1 and 2); similar significant reduction was seen in the lateral compartment and tibial plateaus

  • Lower subchondral bone marrow lesions (BMLs) scores were found for the CS group after 6 months compared with the placebo group (Table 5)

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Summary

Introduction

Of all the musculoskeletal conditions, osteoarthritis (OA) has the highest prevalence, affecting a significant percentage of the aging population [1]. The main features of OA include articular cartilage degeneration, subchondral bone abnormal remodeling, and synovial membrane inflammation, leading to joint swelling, synovitis, and pain [2]. Chondroitin sulfate (CS) is a major component of the extracellular matrix of cartilage implicated in its elasticity and its resistance to loading. It consists of repeated chains of sulfated and/or unsulfated d-glucuronic acid and N-acetyl-d-galactosamine residues [4]. CS has shown to have a positive effect on some of the OA-related pathological processes involving the synovial tissue and subchondral bone [7]. Chondroitin sulfate (CS) is a major component of the extracellular matrix of many connective tissues, including cartilage, bone, skin, ligaments, and tendons

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