Abstract
Purpose: Glucosamine-based massage cream has been developed by an Israeli company (Manon Pharmaceuticals). Prior literature indicates that a single study performed about 30 years ago has demonstrated a certain efficacy of a glucosamine containing topical formulation for the treatment of gonarthrosis.
Materials and Methods: Eighty patients suffering from grade 2–3 degenerative changes of the knee were randomized and received either a menthol based cream or a glucos-amine-containing formulation. The study was approved by the institutional Helsinki committee. Patients were evaluated pre treatment using the VAS pain measure as well as the KSS score. Standardized radiographs were evaluated as described by Ahlbeck to evaluate the stage of articular cartilage degeneration. Exclusion criteria were grade 1 and 4, inflammatory arthritis and Charcot arthropathy. Patients employed the massage cream on a tid basis for a minimum of one month. Patients were followed for a minimum of 6 months. Medication usage was evaluated during follow-up.
Results: Improvement was noted in 32 of 40 patients (defined as VAS improvement by 20 percent or more) of the experimental group and in 12 of 40 patients of the control group. KSS scores improved in 21 of 40 patients of the experimental group by 5 points or more at the 6 months time-point. Only 5 patients in the control group demonstrated similar improvement.
Conclusions: Some improvement is noted in symptoms by the use of topically applied glucosamine- containing massage cream in knee arthrosis. However many questions remain un-answered. What is the mechanism of action of topically applied glucosemamine? Does it penetrate skin and capsule to reach the cartilage and synovium? What is the role of the placebo effect in the treatment of joint symptoms in osteoarthritis, a disease typified by an undulating clinical course.
The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.
