Comparison practice condroprotective effectiveness of the glucosamine sulfate and intraarticular hyaluronic acid on the induced experimental model of rats knee osteoarthritis.

Background and aim: Osteoarthritis (OA) is the most common chronic joint disease in the world leading to pain and functional loss. The aim of the treatment of OA is to increase the quality of life with reduction of the pain and disability. Commonly used treatments are; medical treatments like simple analgesics and non-steroidal anti-inflammatory drugs, exercise, physical therapy procedures, intra-articular agents like steroids and hyaluronic acid, auxilliary equipment, work-occupation therapy, patient education, supporting methods like glucosamine-chondroitin sulfate preparations and topical capsaicin and also surgical methods for treatment of the osteoarthritis. Hyaluronic acid is used for a long time on cartilage injuries. In-vitro studies have been shown that hyaluronic acid reduces leucocyte functions and affects the functions of the cell proliferation, migration, chemotaxis and phagocytosis. Hyaluronic acid is used to resolve the pain and slow down the disease progression on humans osteoarthritis joints. Hyaluronic acid reduces the proteoglycan loss of growth plate and articular cartilage on the rats. It also prevents structural damage of cartilage and reduces acute inflammation in arthritic joints on the rats. Glucosamine is an amino monosaccharide nutrient and precursor of the disaccharide unit of glycosaminoglycan which is the building block of the proteoglycan component of the cartilage matrix. It has been demonstrated that N-acetylglucosamine inhibits nitric oxide, cyclooxygenase?2 (COX-2), and IL-2 production in cultured human articular chondrocytes.Objectives: The aim of this study is to compare the condroprotective efficacies of intraarticular glucosamine-sulfate and hyaluronic acid administrations in an experimental osteoarthritis model in rats.Material and methods: 15 rats for each groups (total 45) were used in this study. The knee joint was approached by means of an arthrotomy with a medial para patellar incision under sterile conditions. The patella was dislocated laterally to expose the anterior cruciate ligament (acl) and the acl was resected. The resection was controlled with an anterior drawer test. Two weeks later after the surgery, three injections were adminestered intraarticularly per week. In group 1 (glucosamine-sulphate group) 12mg/0.06 cc glucosamine-sulfate was injected with insulin injector to the intraarticular cavity. In group 2 (hyaluronic acid group) 50 ug/0.05 cc hyaluronic acid was injected with an insulin injector to the intraarticular cavity. In group 3 (control group) 50 ul/0.05 cc %0.9 NaCl was injected to the intraarticular cavity. The rats were sacrificed eight weeks later and the preparation were evaluated, histologic ally.Findings: In the osteoarthritic rat knee joints, the histopathological effects of tissue regeneration of glucosamine sulfate and HA application compared to the control group were shown to be statistically significant.Conclusion: Glucosamine sulphate administration can be accepted as an alternative treatment protocol in the treatment of osteoartritis in the knee joint.Key Words: Glucosamine sulphate, hyaluronic acid, rats, osteoarthritis, anterior cruciate ligament.