Gumustas Seyit Ali, Oznam Kadir, Mutlu Cagri Ata, Kaya Yasin Emre, Yilmaz Ibrahim, Isyar Mehmet, Guzelant Aliye Yıldırım, Guler Olcay, Akkaya Semih, Mahirogullari Mahir
Department of Orthopaedic and Traumatology, Dr.Lutfi Kirdar Kartal Training and Research Hospital, 34865, Istanbul,Turkey.
Department of Orthopaedic and Traumatology, Istanbul Medipol University School of Medicine, 34214Istanbul, Turkey.
Open Orthop J. 2017 May 31;11:533-540. doi: 10.2174/1874325001711010533. eCollection 2017.
Osteochondral injuries constitute an entity that is widespread and can be seen in patients of all ages. Actual treatment modalities aim to relieve pain, obtain full range of movement of the joint, and improve the quality of life. There are many slow-acting chondroprotective agents prevalently used in the United States that are classified as nutritional support but not as medicines . This study presents the importance of clinical adverse effect profiles as well as the pharmacological mechanism of action and application of combinations of drugs that are widely prescribed and not subjected to control.
Electronic databases were searched with keywords about the chondroprotective drugs without any language restriction. Evaluations of the descriptive statistics were represented Microsoft Office Excel 2010 lists in the form of a mean±standard deviation or frequency (%). The first evaluation showed that 1502 studies were potentially relevant. Following exclusion of the 1277 studies which were not clinical, full versions of the remaining 225 studies were subjected to further evaluation. No controlled, blinded, randomized and/or comparative studies met the inclusion criteria of the study, and no studies evaluated the comparative clinical results of the hyaluronan of different molecular weights.
The findings of this study concluded that especially when prescribing drugs with ingredients like GS and CS, many patients' pre-existing conditions must be considered, such as whether the patient has a glucose intolerance or not. Additionally, mineral toxication should be considered since the drugs contain minerals, and after the application of injected hyaluronan, complications should be considered.
Clinical, controlled and comparative studies about the use of chondroprotective drugs must be performed to define the benefits of these drugs, if any, in order to determine the most suitable time for operative intervention.
骨软骨损伤是一种常见病症，可见于各年龄段患者。实际治疗方式旨在缓解疼痛、恢复关节的全范围活动并提高生活质量。在美国，有许多起效缓慢的软骨保护剂被广泛用作营养支持而非药物。本研究阐述了临床不良反应概况的重要性，以及广泛使用且不受管控的联合用药的药理作用机制和应用情况。
使用有关软骨保护药物的关键词检索电子数据库，无语言限制。描述性统计评估以Microsoft Office Excel 2010列表形式呈现，以均值±标准差或频率（%）表示。初步评估显示有1502项研究可能相关。在排除1277项非临床研究后，对其余225项研究的全文进行进一步评估。没有对照、双盲、随机和/或比较研究符合该研究的纳入标准，也没有研究评估不同分子量透明质酸的比较临床结果。
本研究结果表明，尤其是在开具含有GS和CS等成分的药物时，必须考虑许多患者的既往病史，例如患者是否有葡萄糖不耐受情况。此外，由于药物含有矿物质，应考虑矿物质中毒情况，并且在注射透明质酸后，应考虑并发症。
必须开展关于软骨保护药物使用的临床、对照和比较研究，以确定这些药物（如果有）的益处，从而确定最适合进行手术干预的时机。
