Diet, Exercise and Glucosamine Fail to Prevent Knee Osteoarthritis Save

Primary prevention of osteoarthritis is an ideal goal for which there has been little success in clinical trials.

A double blind and placebo-controlled trial studied the impact of a diet-and-exercise program and of oral glucosamine sulfate as preventative strategies to reduced the incidence of knee osteoarthritis. The study enrolled 407 middle-aged women with a body mass index ≥ 27 kg/m(2) without clinical signs of knee osteoarthritis at entry. Primary outcome was determined after 2.5 yrs as the incidence of knee osteoarthritis, defined as Kellgren & Lawrence grade ≥ 2, joint space narrowing of ≥ 1.0 mm, or clinical knee osteoarthritis (clinical and radiographic American College of Rheumatology criteria).

Compliance was high as 90% of  subjects completed the trial.  After 2.5 yrs, 17% of all knees showed incident knee osteoarthritis, but no significant effect of either intervention was found. Both interventions alone showed nonsignficant reductions in KL2 knee osteoarthritis odds ratio [OR] 0.69; 95% CI, 0.39-1.21 for the diet-and-exercise program and OR 0.60; 95% CI, 0.31-1.12 for the glucosamine intervention). However these benefits were nullified in those who received both interventions (OR 0.97; 95% CI, 0.55-1.71).

No significant main effects of the diet-and-exercise program and of glucosamine sulfate were found on incident knee osteoarthritis. Nevertheless, this trial provides valuable insights for future trial design for preventive osteoarthritis studies.

Nevertheless, the CDC continues to advocate that exercise be an important part of OA management.  A recent Cochrane metanalysis, shows signficant benefits in osteoarthritis patients undergoing land based exercise.  Improvements in pain, function and qualiyt of life was seen in multiple studies. (Citation source: http://buff.ly/1MmDPsI)