Eating Chondroitin Humble Pie

For a number of years I have posted results of studies that suggest the use of chondroitin sulphate by patients with osteoarthritis is a waste of time and money. Now it's time for me to eat my words. A clinical trial, published in the Annals of the Rheumatic Diseases, has examined the effect of chondroitin treatment on the joints of patients with knee osteoarthritis, with, to my surprise, beneficial results.

This was a multicentre, randomized, double-blind, controlled trial in 69 patients with osteoarthritis of the knee; they all had clinical signs of inflammation of the synovial membranes within the joint. They were randomly allocated to take 800 mg of chondroitin sulphate or placebo once a day for six months, followed by a further six months in which all patients took CS 800 mg once daily. The volume of cartilage and the lesions in the bone marrow just below the cartilage were assessed by magnetic resonance imaging (MRI) at baseline, and at 6 and 12 months; the synovial membrane thickness was measured at baseline and at 6 months.

After the first six months the chondroitin group had a significantly lower loss of cartilage for three measures in the joint (i.e. the entire knee, in the lateral compartment, and at the tibial plateaus). These differences to the controls persisted at 12 months. In addition, there were significantly fewer bone marrow lesions in the chondroitin group at 12 months. The symptoms of the disease were similar however between the two groups. The chief investigator, Prof Jean-Pierre Pelletier of the University of Montréal, said that this study shows that chondroitin sulphate is a safe drug with an overall positive effect on osteoarthritis; it significantly reduced the volume of cartilage loss, and showed for the first time positive effects on other structural changes seen in this disease.

Indeed, this study demonstrates that chondroitin sulphate slows the progression of knee osteoarthritis. Earlier studies have suggested this, but they have been countered by other studies showing little or no effect. It seems that I, and other non-experts, have been premature in our dismissal of the benefits of this "Alternative Medication". My apologies – perhaps I was misled by the lack of benefit on symptomatology.

I must confess, also, that I have been giving our Bernese Mountain dog chondroitin tablets for the last two years; he has early radiological evidence of lax hip joints and I hope to avoid development of hip dysplasia for as long as possible. Certainly he displays no side effects, and has not developed a limp, so maybe the chondroitin is helping! We shall see.