ABSTRACT
Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391 Pathophysiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392 Treatment Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
Pain Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394 Biomechanics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394 Weight Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395 Reduce Inflammation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395 Regenerate Cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
Nutritional Substrates for Cartilage Repair and Regeneration . . . . . . . . . . . 397 Glucosamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397 Chondroitin Sulfate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 398 S-Adenosyl Methionine (SAMe) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399 Hyaluronic Acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399 Omega-3 Fatty Acids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400 Vitamin C (Ascorbic Acid) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401 Avocado/Soybean Unsaponifiable Residues (ASU) . . . . . . . . . . . . . . . 401 Niacinamide (Vitamin B3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401 Additional Nutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402
Duration and Selection of Joint Support Supplementation . . . . . . . . . . . . . . 402 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403
Osteoarthritis (OA) is characterized by progressive degeneration of articular cartilage with resultant joint space narrowing, cysts, and osteophyte formation. OA occurs and progresses when regeneration cannot keep pace with the rate of cartilage loss. Joint deterioration occurs when the biomaterial properties of the articular cartilage are inadequate or the load on the joint is excessive.1,2 Joint vulnerability can stem from injury, malalignment, muscle weakness, genetic and
ethnic predisposition, aging, and nutritional factors. Additional insult on the total joint load can come from the extra weight burden associated with obesity and certain physical activities (i.e., high-impact sports). Nutritional interventions and in particular certain joint support supplements can play a key role in the management of patients with OA.
