Chondroitin sulfate has many biological activities and can be used as medicine and healthy food. It is mainly used in osteoarthritis (OA) and coronary atherosclerotic heart disease (CHD). Chondroitin sulfate is extracted from the cartilage of pigs, cows, fish, and chickens. Mr is between 10 * 103~50 * 103.

Chondroitin sulfate/glucosamine has been used as a prescription or over-the-counter drug for the treatment of OA in Europe for more than 20 years and has been approved as a government compensatory health insurance. The raw material of chondroitin sulfate for drug production is a high purity (95%) and low MR.

Chondroitin sulfate from Australia belongs to nutritional and health products. Common chondroitin sulfate products on the market are used to prevent and treat OA. Australia classifies nutritional and health medicines into adjuvant medicines, which are administered by the Drug Administration of the Federal Ministry of Health.

Chondroitin sulfate is an over-the-counter drug in Japan. Eye drops are used to supplement tears or protect the cornea. Oral preparations are arthralgia analgesics.

In 1992, CosaminDS, a patented product of chondroitin sulfate and glucosamine produced by Bioiberica AS Pharmaceutical Company in Spain, was examined and approved by FDA in accordance with the Regulations on Drug, Food and Cosmetics Administration. The United States has identified such cartilage protectors as dietary supplements rather than drugs.

In developed countries, OA is a common joint disease. The most common symptoms are pain and loss of function caused by articular cartilage damage. About 27 million people in the United States suffer from OA, and annual social consumption is estimated to exceed $60 billion. Owing to the aging of the population, the number of OA patients has increased rapidly. It is estimated that the number of OA patients will double between 2005 and 2030, which will become one of the major social and economic burdens.

As a symptomatic slow-acting drug for OA, chondroitin sulfate has the following clinical benefits:

(1) relieving pain;

(2) improving function;

(3) reducing consumption of non-steroidal anti-inflammatory drugs or analgesics.

A recent randomized, double-blind clinical trial examined the therapeutic effects of glucosamine, chondroitin sulfate, and their combination on OA. The results showed that hyaluronic acid glucose and chondroitin sulfate could improve the pain of some moderate and severe patients. Chondroitin sulfate significantly alleviated joint swelling in patients with mild OA. Chondroitin sulfate can also improve joint mobility.

In recent years, randomized clinical trials have shown that oral chondroitin sulfate is effective in treating knee arthritis, finger arthritis, and hip arthritis. Oral chondroitin sulfate has a slow onset, but it has a long-lasting effect. At the same time, its safety and tolerance are very good. In addition, recent studies of high methodological quality have yielded encouraging results that chondroitin sulfate can inhibit joint space narrowing.

The author believes that when referring to the results of clinical trials reported abroad, attention should be paid to the animal sources, quality standards, and Mr. of chondroitin sulfate raw materials used; when making clinical trials with domestic products, according to their indications, the production process of raw materials should be designed, and the composition and MR should be well controlled.

There are three mechanisms of chondroitin sulfate’s clinical effects:

(1) directly activating the production of intercellular mediators through chondrocytes;

(2) inhibiting inflammatory mediators;

(3) inhibiting cartilage degeneration.

In conclusion, the application of chondroitin sulfate is reasonable and can be used as a good choice for the treatment of OA.

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At present, the direction of arthritis is mistakenly pointed to the knee joint, so the main focus is on the knee joint. At present, there are nonoperative treatment (conservative treatment) and surgical treatment. Surgical treatments of common knee arthroscopy are debridement and knee replacement. Neither of these two methods can cure the knee joint. Doctors in the United States conducted a comparative study in 1995 and found that joint debridement did not do the same “effect” but they could not explain the phenomenon.

The etiology of knee osteoarthritis is complicated. The main pathological features of knee osteoarthritis are focal articular cartilage sclerosis, marginal osteophyte formation, and joint deformity. Age, obesity, inflammation, trauma, and genetic factors are related to the disease.

Hesitation trauma, excessive strain, an articular cartilage defect, degeneration, and subsequent reactive synovitis, the release of inflammatory factors, coupled with the reduction of Hyaluronic acid in the knee joint, a series of changes, accelerate the loss of cartilage matrix, resulting in articular cartilage surface damage and subchondral bone exposure. Therefore, the protection of osteoarthritis is the key to the treatment of this disease.

Since Peyron first used the intra-articular injection of SHP (sodium hyaluronate) in the treatment of OA (osteoarthritis) in the 1970s, SHP has been used in the clinic for 30 years. Most people believe that the effective use of intra-articular injection of sodium hyaluronate can improve the inflammatory reaction of synovial tissue, enhance the viscosity and lubrication function of joint fluid, and protect Guan.

Ganglion cartilage, which promotes the healing and regeneration of articular cartilage, alleviates pain, increases joint mobility, delays the process of disease, is the first choice for the treatment of mild to moderate osteoarthritis. In addition to relieving pain, SHP can also improve joint function, treatment duration is long, and no systemic toxic side effects.

Injection of analgesic fluid in pain spots and the joint cavity can reduce inflammation and detumescence, relieve pain and improve microcirculation. Sodium hyaluronate is a component of joint synovial fluid and cartilage matrix. Intra-articular injection of sodium hyaluronate can improve intra-articular lubrication and alleviate intra-articular friction.

Intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis pain relief, improving knee function, control the development of knee osteoarthritis plays a very important role. For knee osteoarthritis, we should early diagnosis, early treatment, a variety of excellent means of comprehensive treatment to obtain satisfactory results.

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