The impact of glucosamine, chondroitin sulfate, and Harpagophytum procumbens on knee osteoarthritis features as assessed by MRI.

Osteoarthritis (OA) is a persistent joint condition resulting from the disturbance of joint homeostasis due to various systemic and biomechanical factors. This condition is marked by the deterioration of cartilage and other joint tissues, accompanied by low-grade inflammation that can lead to symptoms such as pain, diminished function, and disability. Objective. The study assessed the impact of frequently prescribed pharmacological treatments on structural changes in the knee among participants experiencing progressive OA using MRI. Material and Methods. The study was conducted on a number of 34 patients with bilateral knee OA (22 women and 12 men), aged between 35 and 78 years. Selected patients were evaluated at the initial visit, then 6 months after administration of glucosamine, chondroitin sulfate and Harpagophytum procumbens therapy. From a clinical point of view, morning stiffness and pain intensity (visual analogue scale – VAS), knee mobility and functionality were quantified with the help of the WOMAC and the quality-of-life questionnaire (HAQ – 20 items). In terms of imaging evaluation bilateral knee MRI was performed. Measurements of the cartilage thickness were performed both at the level of the lateral and medial condyles, as well as intercondylar. Outcomes. The average age of onset of OA was 55.06 ± 10.05 years. The mean duration of the disease at the time of inclusion was 6.32±3.45 years. The mean VAS value at baseline was 73 ± 9.90 mm. The degree of OA was quantified on the Kellgren-Lawrence scale up to grade III disease severity. The use of slow-acting symptomatic agents (SYSADOA) resulted in a reduced need for administration of analgesic and anti-inflammatory therapy, leading to diminished side effects associated with these drugs. Thus, spontaneous pain and assessed functionality improved significantly, with symptom improvement reaching up to 25%. In addition, SYSADOA therapy resulted in a delay in imaging progression of knee OA, with improvement in femoral hyaline cartilage thickness in all compartments. The MRI results did not show a statistically significant difference between the thickness of the femoral hyaline cartilage, between the first and the second imaging evaluation. Thus, between baseline and the 6-month visit, femoral cartilage thickness appears to be maintained, even showing a slight increase after SYSADOA treatment. Conclusions. SYSADOA administration delays the radiographic progression of knee OA, with preservation, even modest improvement in hyaline cartilage thickness, making MRI an important tool in the evaluation and monitoring of OA. An increase in patients’ quality of life in terms of both pain and functionality was also reported. [ABSTRACT FROM AUTHOR]