What foods contain chondroprotectors? Chondroprotectors for joints

The most complete answers to questions on the topic: “natural chondroprotectors for joints.”

Chondroprotectors are medications that are used to improve recovery cartilage tissue joints, as well as to slow down degenerative processes that gradually destroy joints and lead to various musculoskeletal diseases musculoskeletal system. Chondroprotectors may include various natural or artificial components that are normally found in the cartilage tissue of joints. Most often in preparations of Russian and foreign production substances such as chondroitin sulfate and glucosamine are used, each of which has its own effect.

Insufficient physical activity during the workday is a hallmark of office work. Immobility, prolonged stay in uncomfortable position provoke excessive stress on the joints and cause pain, discomfort and gradual destruction of cartilage. Therefore, office workers are recommended to regularly do gymnastics, and they also need to take products that protect and restore cartilage tissue, chondroprotectors. For example, the dietary supplement “Glucosamine-Maximum” has proven itself well - a chondroprotector containing two active substances: glucosamine and chondroitin. They are natural structural elements of healthy cartilage tissue, are well absorbed due to their natural nature and stimulate metabolic processes in cartilage cells, restoring the structure of cartilage tissue.

NOT A MEDICINE

In total, there are 3 generations of chondroprotectors. The first two generations of chondroprotectors are, in fact, mono-drugs, that is, these drugs contain only one active substance or component. However, in Lately a new 3rd generation has appeared. Third generation chondroprotectors combine more than two active components from previous generations, which makes this group of medications more effective. Also, this group of new drugs may contain diclofenac or ibuprofen, which have a good anti-inflammatory effect.

It is worth noting that chondroprotectors are more effective for preventive purposes than for therapeutic purposes (

these medications protect cartilage tissue to a greater extent than restore it

Joint structure

A joint is a movable joint of bones that performs two functions at once - supporting and motor. Some joints may have supporting structures that can strengthen the joint or make it more mobile (

ligaments and joint capsule

), as well as to equalize the discrepancy between the articular surfaces of the bones (

menisci, articular discs

). Joints may consist of two bones (

simple joints

) or from three or more bones (

complex joints

Each joint is fed by a well-branched arterial network of vessels. As a rule, in this network includes from 3 to 7 - 8 arteries. There is also a nerve network in the joint, which is formed by both sympathetic and spinal nerves.

Each joint consists of the following elements:

articulating bones;
joint capsule;
articular cavity;
ligaments;
joint cartilage;
periarticular tissues.

Articulating bones Each joint consists of at least two end sections of articulating bones. The articular surfaces of bones are most often congruent, that is, they completely or almost completely correspond to each other. For example, the articular surface of one bone most often looks like an articular head, while the other looks like an articular cavity. Each end section of the articulating bones is covered on top with cartilage tissue, which plays the role of a shock-absorbing substance.

Movements in the joints can be made along one, two or even three axes. In addition to flexion and extension, the joint can perform movements such as adduction and abduction, rotation, and multi-axis rotational movement.

It is worth noting that the surfaces of articulating bones are very often compared to figures from geometry.

Based on their shape, the following types of joints are distinguished:

Cylindrical joint is a congruent joint in which movements (rotations) are carried out only in one plane. An example of a cylindrical joint is the articulation between the radius and ulna, in which movements along the axis are carried out inward (pronation) or outward (supination).
Trochlear joint resembles a cylindrical one, but unlike it, it has a recess for connection with the ridge of another articular surface. An example of a trochlear joint is the interphalangeal joint or ankle joint.
Helical joint It is also a uniaxial joint in which the articulating limbs move in a helical manner. A typical example of a helical joint is elbow joint.
Ellipsoidal joint is a joint in which movement is possible in two planes. The articular surfaces in this type of joint have an oval or ellipsoidal shape (the joint between the first cervical vertebra and occipital bone).
Condylar joint is an intermediate form of the ellipsoidal and trochlear joint. Such joints are the temporomandibular joint and the knee.
Saddle joint. In this joint, the articular surfaces are absolutely equivalent and located at right angles to each other. It is thanks to this arrangement that movements in the saddle joint are carried out in two mutually perpendicular planes. An example of a saddle joint is the calcaneocuboid joint (between the calcaneus and the cuboid bone of the tarsus), as well as the carpometacarpal joint thumb brushes (between thumb and trapezoid bone of the metacarpus).
Flat joint characterized by the fact that it has flat articular surfaces that almost completely correspond to each other, and are also slightly curved. It should be noted that these articular surfaces resemble a ball, as a result of which the movements are carried out as a sliding type. For example, the vertebral joints, forming the spinal column, increase the amplitude of circular movements in it.
Ball and socket joint is one of the most mobile joints. This is due to the fact that the articular head is much larger than the articular cavity, which provides a large range of movements in it. One of the differences between a ball and socket joint is complete absence ligaments (shoulder joint).
cup joint, in fact, it is one of the varieties of a ball-and-socket joint. In this joint, the head of the bone is located deep in the articular cavity, and along its edges there are labrum(consists of strong connective tissue) that strengthens the entire joint. Movement in a bowl-shaped joint is possible in all planes, but to a slightly lesser extent than in a ball-and-socket joint. An example of a cup joint is the hip joint.

Joint capsule The joint capsule is a protective shell that consists of dense connective tissue (mainly collagen fibers) that allows it to withstand heavy loads. The articular capsule is attached to the articulating bones, directly next to the articular surfaces or slightly retreating from them. The capsule hermetically surrounds the cavity of each joint and to a large extent protects it from various types of external damage (impacts, sprains, tears). Connective tissue fibers of various muscle tendons and ligaments are also woven into most joints. The joint capsule is heterogeneous and consists of two shells.

The following membranes are distinguished in the joint capsule:

Fibrous membrane is a thick and dense membrane that is formed from fibrous connective tissue. The fibrous membrane of the articular capsule is quite often reinforced by ligaments, which, interwoven into it, increase its strength. Attaching to the bone, this shell gradually transitions into the periosteum.
Synovial membrane is the inner membrane of the articular capsule and covers almost the entire surface of the joint cavity with the exception of the articular surfaces. The synovium produces synovial fluid through numerous tiny synovial villi. This liquid, in turn, performs many important functions. Firstly, synovial fluid nourishes the cartilage tissue of the joint. Secondly, it eliminates the friction that occurs between the articular surfaces of articulating bones. Third, synovial fluid moisturizes the joint. Also, the synovial membrane largely protects the joint cavity from the entry of various pathogens into it. It is worth noting that the synovial membrane contains most of the nerve endings of the joint.

Articular cavity The cavity of each joint is a slit-like and hermetically sealed space. External borders the joint cavity is the synovial membrane (the membrane that lines inner part joint capsules), and the internal ones are the articular surfaces of the articulating bones.
Ligaments

Most joints are strengthened by ligaments - dense and durable formations consisting of connective tissue. Ligaments can not only strengthen the articulation between bones, but also direct or inhibit movement in them. Typically, ligaments are located outside the joint, but in some large joints, such as the knee and hip, they are woven into the joint capsule to increase strength.

In addition to strength, ligaments have elasticity, resilience and extensibility. These mechanical properties depend on the ratio of collagen and elastin fibers that are part of them.

Joint cartilages

Cartilage is an elastic and dense intercellular substance that covers the articular surfaces. The cartilage tissue completely lacks nerves and blood vessels. In turn, cartilage is nourished thanks to synovial fluid, which is produced by the synovial membrane and contains all the necessary nutrients.

Cartilage consists of the following components:

Chondroblasts- the youngest and undifferentiated cells of cartilage tissue. Chondroblasts participate in the formation of the intercellular substance of cartilage and are also capable of actively dividing. Most of these cells are found deep in the cartilage tissue. It is worth noting that chondroblasts can not only produce components of the intercellular substance, but also enzymes that destroy this substance, thereby regulating the ratio of these components. During the process of differentiation, chondroblasts transform into chondrocytes.
Chondrocytes are the main cells of cartilage tissue, but at the same time they quantitative ratio does not exceed 10% of the total mass of cartilage. These cells are also responsible for the production of all components of the intercellular substance, which, in turn, forms the amorphous substance of cartilage, as well as fibrous structures. When producing intercellular substance, chondrocytes gradually wall themselves up in special cavities (lacunae). It is worth noting that only young forms of chondrocytes are capable of division.
Intercellular substance is a derivative of both chondroblasts and chondrocytes. The composition of the intercellular substance of cartilage tissue includes interstitial water (intercellular), collagen fibers (strong protein strands), as well as proteoglycans (complex protein molecules). Interstitial water (60–80%) plays the role of a shock absorber and ensures the incompressibility of cartilage tissue. Water is also needed to transport nutrients to more deep tissue, for nutrition of young and mature cartilage cells (chondroblasts and chondrocytes). Collagen fibers (15–25%) are randomly arranged protein strands. It is these strands that surround chondrocytes and chondroblasts and protect them from excessive mechanical pressure. Proteoglycans (5 - 10%) in the cartilage tissue of the joints are glycoproteins (protein molecules associated with carbohydrate residues), in which the carbohydrate part is represented by sulfated glycosaminoglycans (carbohydrates that contain an amino group). Proteoglycans perform an important function, as they bind cartilage fibers and water, and also prevent the accumulation of calcium salts in it (mineralization process).

Chondroitin sulfate and glucosamine

Chondroitin sulfate, as part of the proteoglycan to which it is attached, is the main component of ligamentous tissue. It is this that determines the integrity of connective tissue in general. Chondroitin sulfate is the main component of cartilage, as well as synovial fluid of the joint. Its sulfate group forms electrostatic repulsion, which is what determines the protection of cartilage from abrasion - that is, it provides the shock-absorbing function of the intercellular matrix. The same thing happens in the intra-articular fluid. That is, the presence of chondroitin sulfate in the connective tissue affects the production of the most important protein - collagen and aggrecan - a large protein complex that is the most important in the intercellular matrix and forms all the structures in musculoskeletal system. And, glucosamine is a component of chondroitin sulfate, a simpler polysaccharide from which chondroitin is subsequently synthesized. Thus, the following main functions of these substances can be distinguished:

From this list it becomes clear that chondroprotectors can be called the main substances that determine the health of the musculoskeletal system. They are responsible for the synthesis of all structural components of ligamentous tissue.

There are many drugs of different generations - chondroprotectors, mainly based on glucosamine and chondroitin sulfate. Now they are mandatory in the treatment of diseases such as osteoarthritis, arthritis and many others, but are they really that effective? These drugs are taken orally, as well as directly into the tissue in the form of injections. But it is very important to use them every day with food.

Cartilage, skin of fish and animals are very rich in these substances. It is also generally accepted that these substances can be obtained by consuming products containing gelatin, a product of collagen hydrolysis. These are: rich broths made from bones and cartilage, jellied meat, aspic. But most of all they are found in the tissues of salmon fish (salmon, salmon, trout, chum salmon). In addition, some substances of plant origin have a similar chondroprotective effect. Thus, unsaponifiable fats (lipids) of avocado and soy are also now classified as chondroprotectors.

But is chondroitin sulfate, glucosamine and other chondroprotectors really so strong? positive effect? Let's try to figure this out.

In the literature, there is a large number of expert opinions regarding chondroitin sulfate and glucosamine. Thus, on the basis of the Orenburg State Medical Academy, long-term studies were carried out on the effect of drugs containing chondroitin sulfate on the treatment process for patients with stage 1-3 coxarthrosis. Studies have shown a decrease in pain at rest, when walking, when walking up stairs (on the WOMAC scale), but the drugs gave a pronounced effect only with long-term use.

J.J. Raithlac et al, in 2012, conducted a large placebo-controlled study of chondroitin sulfate preparations using MRI data. The study lasted 48 weeks, the drug was taken by patients with osteoarthritis of the knee joint. First of all, the improvement in the condition of the cartilage was assessed. As a result, experts noticed a decrease in pain, an increase in cartilage volume and the number of osteoblasts compared to patients using a placebo.

Herrero-Beaumont G. et al., in 2007, conducted a similar, double-blind study of glucosamine in patients with osteoarthritis. With long-term consumption, the effectiveness of this substance has also been proven (VAS and WOMAC scale) in dosages of 1 mg per day.

Works by Redda D.J. in 2006, also gave satisfactory assessments of the combined use of glucosamine and chondroitin sulfate in relieving pain in osteoarthritis.

As for the unsaponifiable fats of soy and avocado (these are the so-called “healthy” fats that do not interact with alkali in the body and do not become solid “soaps”) - these substances relatively recently began to be considered chondroprotectors and they began to be used in the treatment of musculoskeletal diseases. Avocado and soybean oils contain a number of biologically active components - phytosterols, stigmasterol, beta-sitosterol. It has long been experimentally proven that phytosterol and stigmasterol have anti-inflammatory and mild analgesic effects (De Djong A, Plat.J - 2003). Based on these data, a number of studies have been conducted on the possibility of using preparations of unsaponifiable fats from soy and avocado for the treatment of diseases of the musculoskeletal system. A short (three-month) double-blind placebo study conducted by Appleboom T. et al showed that the use of these substances for knee arthrosis in 70% of subjects led to a 2-fold reduction in the consumption of anti-inflammatory non-steroidal drugs.

Thus, analyzing all the above studies, we can make a logical conclusion that the use of glucosamine, chondroitin sulfate and soy and avocado fats give a positive effect only with their long-term and constant use, as well as as additional drugs during treatment with other non-steroidal anti-inflammatory drugs.

Since it is necessary to use these substances for diseases of the musculoskeletal system long time(preferably constantly, since they directly affect the production of cartilage, intra-articular fluid and other connective tissue), it is quite rational and correct to take these substances with food, with the products in which they are contained. This is why it is important to include foods containing chondroprotectors in your connective tissue diet.

Products – chondroprotectors

The most common products - chondroprotectors - are products containing gelatin. Gelatin is partially hydrolyzed animal collagen, that is, the main protein of connective tissue. It is very useful for consumption, since part of it during metabolism is converted into oligosaccharides - extremely useful substances for immunity and digestion, and part of it is able to reach connective tissue and “patch” it.

Jelly (gelatin based)
Rich broth from fish or lean meat (be sure to cook the bones for a long time)
Aspic
aspic

However, it has been scientifically proven that fish chondroitin sulfate is 100 times more biologically active than animal origin (Sorokumov I.M. et al., 2007). Most of all chondroitin sulfate is found in shark and stingray, however, not everyone can afford to eat such rare foods every day. Not much smaller than his salmon fish:

Salmon
Salmon
Trout

In diet therapy for diseases of the musculoskeletal system, it is important to properly prepare fish. It is recommended to cook it for a long time- get rich broth. But it is best to eat it half-raw or lightly pickled. When frying, unfortunately, most of the active substances are destroyed.

It is useful to include avocado and soy in your diet in different forms(tofu, soy foam, sprouted soybeans, soybean oil). Avocado is a vegetable containing polyunsaturated fatty acid, which are not only chondroprotectors, but also strong antioxidants, which is also very important in complex therapy diseases of the musculoskeletal system. Soy products are high-protein substances - and this is very important for creating a protein diet, which at the same time should be low-calorie (for diseases of the musculoskeletal system this is very important).

To summarize, let's say that natural chondroprotectors, which enter the body with food, are no less important in general, complex therapy for various diseases of the musculoskeletal system.

Chondroprotectors are medications that are used to improve the restoration of cartilage tissue in joints, as well as to slow down degenerative processes that gradually destroy joints and lead to various diseases of the musculoskeletal system. Chondroprotectors may include various natural or artificial components that are normally found in the cartilage tissue of joints. The substances most often used in Russian and foreign-made drugs are chondroitin sulfate and glucosamine, each of which has its own effect.

In total, there are 3 generations of chondroprotectors. The first two generations of chondroprotectors are, in fact, mono-drugs, that is, these drugs contain only one active substance or component. However, recently a new 3rd generation has appeared. Third generation chondroprotectors combine more than two active components from previous generations, which makes this group of medications more effective. Also, this group of new drugs may contain diclofenac or ibuprofen, which have a good anti-inflammatory effect.

It is worth noting that chondroprotectors are more effective for preventive purposes than for therapeutic purposes ( these medications protect cartilage tissue to a greater extent than restore it).

Joint structure

A joint is a movable joint of bones that performs two functions at once - supporting and motor. Some joints may have supporting structures that can strengthen the joint or make it more mobile ( ligaments and joint capsule), as well as to equalize the discrepancy between the articular surfaces of the bones ( menisci, articular discs). Joints may consist of two bones ( simple joints) or from three or more bones ( complex joints).

Each joint is fed by a well-branched arterial network of vessels. As a rule, this network includes from 3 to 7 – 8 arteries. There is also a nerve network in the joint, which is formed by both sympathetic and spinal nerves.

Each joint consists of the following elements:

articulating bones;
joint capsule;
articular cavity;
ligaments;
joint cartilage;
periarticular tissues.

Articulating Bones

Each joint consists of at least two end sections of articulating bones. The articular surfaces of bones are most often congruent, that is, they completely or almost completely correspond to each other. For example, the articular surface of one bone most often looks like an articular head, while the other looks like an articular cavity. Each end section of the articulating bones is covered on top with cartilage tissue, which plays the role of a shock-absorbing substance.

It is worth noting that the surfaces of articulating bones are very often compared to figures from geometry.

Based on their shape, the following types of joints are distinguished:

Cylindrical joint is a congruent joint in which movements ( rotation) are carried out only in one plane. An example of a cylindrical joint is the articulation between the radius and ulna, in which movements along the axis are carried out inward ( pronation) or outward ( supination).
Trochlear joint resembles a cylindrical one, but unlike it, it has a recess for connection with the ridge of another articular surface. An example of a trochlear joint is the interphalangeal joint or the ankle joint.
Helical joint It is also a uniaxial joint in which the articulating limbs move in a helical manner. A typical example of a helical joint is the elbow joint.
Ellipsoidal joint is a joint in which movement is possible in two planes. The articular surfaces in this type of joint have an oval or ellipsoidal shape ( joint between the first cervical vertebra and the occipital bone).
Condylar joint is an intermediate form of the ellipsoidal and trochlear joint. Such joints are the temporomandibular joint and the knee.
Saddle joint. In this joint, the articular surfaces are absolutely equivalent and located at right angles to each other. It is thanks to this arrangement that movements in the saddle joint are carried out in two mutually perpendicular planes. An example of a saddle joint is the calcaneocuboid joint ( between the calcaneus and cuboid tarsal bone), as well as the carpometacarpal joint of the thumb ( between the thumb and the trapezoid bone of the metacarpus).
Flat joint characterized by the fact that it has flat articular surfaces that almost completely correspond to each other, and are also slightly curved. It should be noted that these articular surfaces resemble a ball, as a result of which the movements are carried out as a sliding type. For example, the vertebral joints, forming the spinal column, increase the amplitude of circular movements in it.
Ball and socket joint is one of the most mobile joints. This is due to the fact that the articular head is much larger than the articular cavity, which provides a large range of movements in it. One of the differences between a ball and socket joint is the complete absence of ligaments ( shoulder joint).
cup joint, in fact, it is one of the varieties of a ball-and-socket joint. In this joint, the head of the bone is located deep in the glenoid cavity, and along its edges there is an articular lip ( consists of strong connective tissue), which strengthens the entire joint. Movement in a bowl-shaped joint is possible in all planes, but to a slightly lesser extent than in a ball-and-socket joint. An example of a cup joint is the hip joint.

Joint capsule

The joint capsule is a protective shell that consists of dense connective tissue ( predominantly made from collagen fibers), allowing you to withstand heavy loads. The articular capsule is attached to the articulating bones, directly next to the articular surfaces or slightly retreating from them. The capsule hermetically surrounds the cavity of each joint and largely protects it from various types of external damage ( blows, sprains, tears). Connective tissue fibers of various muscle tendons and ligaments are also woven into most joints. The joint capsule is heterogeneous and consists of two shells.

The following membranes are distinguished in the joint capsule:

Fibrous membrane is a thick and dense membrane that is formed from fibrous connective tissue. The fibrous membrane of the articular capsule is quite often reinforced by ligaments, which, interwoven into it, increase its strength. Attaching to the bone, this shell gradually transitions into the periosteum.
Synovial membrane is the inner membrane of the articular capsule and covers almost the entire surface of the joint cavity with the exception of the articular surfaces. The synovium produces synovial fluid through numerous tiny synovial villi. This liquid, in turn, performs many important functions. Firstly, synovial fluid nourishes the cartilage tissue of the joint. Secondly, it eliminates the friction that occurs between the articular surfaces of articulating bones. Third, synovial fluid moisturizes the joint. Also, the synovial membrane largely protects the joint cavity from the entry of various pathogens into it. It is worth noting that the synovial membrane contains most of the nerve endings of the joint.

Articular cavity

The cavity of each joint is a slit-like and hermetically sealed space. The outer boundaries of the articular cavity are the synovial membrane ( membrane that lines the inside of the joint capsule), and the internal ones are the articular surfaces of the articulating bones.

Ligaments

In addition to strength, ligaments have elasticity, resilience and extensibility. These mechanical properties depend on the ratio of collagen and elastin fibers that are part of them.

Joint cartilages

Cartilage is an elastic and dense intercellular substance that covers the articular surfaces. The cartilage tissue completely lacks nerves and blood vessels. In turn, cartilage is nourished by synovial fluid, which is produced by the synovial membrane and contains all the necessary nutrients.

Cartilage consists of the following components:

Chondroblasts- the youngest and undifferentiated cells of cartilage tissue. Chondroblasts participate in the formation of the intercellular substance of cartilage and are also capable of actively dividing. Most of these cells are found deep in the cartilage tissue. It is worth noting that chondroblasts can not only produce components of the intercellular substance, but also enzymes that destroy this substance, thereby regulating the ratio of these components. During the process of differentiation, chondroblasts transform into chondrocytes.
Chondrocytes are the main cells of cartilage tissue, but their quantitative ratio does not exceed 10% of the total mass of cartilage. These cells are also responsible for the production of all components of the intercellular substance, which, in turn, forms the amorphous substance of cartilage, as well as fibrous structures. When producing intercellular substance, chondrocytes gradually wall themselves up in special cavities ( gaps). It is worth noting that only young forms of chondrocytes are capable of division.
Intercellular substance is a derivative of both chondroblasts and chondrocytes. The composition of the intercellular substance of cartilage tissue includes interstitial water ( intercellular), collagen fibers ( strong protein strands), as well as proteoglycans ( complex protein molecules). Interstitial water ( 60 – 80% ) plays the role of a shock absorber and ensures the incompressibility of cartilage tissue. Water is also necessary to transport nutrients to deeper tissues, to nourish young and mature cartilage cells ( chondroblasts and chondrocytes). Collagen fibers ( 15 – 25% ) are randomly arranged protein strands. It is these strands that surround chondrocytes and chondroblasts and protect them from excessive mechanical pressure. Proteoglycans ( 5 – 10% ) in the cartilage tissue of joints are glycoproteins ( protein molecules bound to carbohydrate residues), in which the carbohydrate part is represented by sulfated glycosaminoglycans ( carbohydrates that contain an amino group). Proteoglycans perform an important function, as they bind cartilage fibers and water, and also prevent the accumulation of calcium salts in it ( mineralization process).

It should be noted that when damaged, cartilage tissue is not restored. In its place, dense fibrous connective tissue is formed, which, although it provides strength, is not capable of performing the function of cartilage tissue. Also, with age, degenerative processes occur in articular cartilage ( excessive accumulation of calcium salts, as well as a decrease in the number of chondrocytes, chondroblasts and amorphous substance), which significantly reduce the volume of cartilage and often lead to osteoarthritis ( joint pathology that occurs against the background of damage to articular cartilage).

In articular cartilage, there are 3 zones with unclear boundaries.

The following zones are distinguished in the cartilage tissue of joints:

Surface zone articular cartilage is in direct contact with the synovial fluid and is the first to gain access to nutrients. It is worth noting that this zone is an amorphous substance with a small content of chondroblasts with a flattened shape.
Intermediate zone represented by larger and more active chondroblasts, as well as chondrocytes.
Deep zone contains highly active chondrocytes and chondroblasts. The deep zone is divided into 2 layers - non-calcifying and calcifying. It is worth noting that few blood vessels penetrate into the last layer. Also, cartilage mineralization processes can take place in this layer.

Periarticular tissues

Periarticular tissues are all joint elements that surround the joint but are located outside the joint capsule.

The following periarticular tissues are distinguished:

Tendons are strands of connective tissue that connect muscles to bones. Tendons contain the protein collagen, which gives strength to these formations.
Muscles actively participate in motor function due to the fact that they are able to contract and relax in a coordinated manner. Each muscle is attached to bones by tendons. The shape of the muscles can be different, but, as a rule, the muscles of the limbs that are directly involved in the movement of the joints have a fusiform shape.
Vessels. Around each joint is a network of lymphatic and blood vessels. Lymphatic vessels are involved in the outflow of lymph ( white liquid that contains proteins, salts and metabolic products) into the nearby venous network. In turn, blood vessels ( veins and arteries) are necessary for the inflow and outflow of blood from organs.
Nerves are part of the peripheral nervous system. Almost all components of the joint ( except cartilage tissue) contain a large number of nerve endings.

Composition of chondroprotectors?

Each medication from the group of chondroprotectors includes one or several components of cartilage tissue.

Composition of chondroprotectors

Active substance	Mechanism of action	Name of medicines containing the active substance
*Single drugs ( contain one active ingredient)*
*Chondroitin sulfate*	Suppresses the activity of the enzyme hyaluronidase, which is produced by chondroblasts and can accelerate the destruction of articular cartilage. It also enhances the formation of hyaluronic acid, which stimulates the process of restoration of articular cartilage tissue. Chondroitin sulfate is an integral component of cartilage tissue. In addition, it has an analgesic and anti-inflammatory effect.	*Chondroitin-AKOS*
		*Chondroxide*
		*Chondrogard*
		*Mucosat*
		*Artrin*
		*Structum*
		*Chondrolone*
	It is an extract from bovine cartilage and bone marrow. Enhances the production of mucopolysaccharides ( carbohydrate part of proteoglycans), which are part of cartilage tissue. Improves the regeneration of articular cartilage tissue, and also inhibits the production of enzymes that destroy the amorphous substance of cartilage.	*Rumalon*
		*Biartrin*
*Glucosamine*	It is one of the important components of cartilage tissue ( part of glycosaminoglycans). Systematic use of glucosamine enhances the synthesis of proteoglycans, as well as collagen fibers. Improves the permeability of the joint capsule and normalizes metabolic processes in cartilage tissue. Has analgesic and anti-inflammatory effects.	*Glucosamine*
		*Elbona*
		*Sustilak*
		*Artron flex*
*Glucosamine sulfate*	In addition to glucosamine, it contains sulfates, which contribute to the fixation of sulfur involved in the formation of chondroitinsulfuric acid ( cartilage component). Participates in the synthesis of glycosaminoglycans, maintains the elasticity of cartilage, improves metabolic processes, and also promotes the retention of intercellular water in cartilage tissue.	*Glucosamine sulfate*
		*Don*
	Accelerates the process of regeneration of joint tissue by suppressing the activity of the enzyme hyaluronidase. To some extent, it improves metabolic processes in cartilage tissue, and also increases the production of intra-articular fluid.	*Arteparon*
*Diacerein*	It is a non-steroidal anti-inflammatory drug that mainly affects articular cartilage. Suppresses the inflammatory process in the joint cavity, which helps reduce the rate of degradation of cartilage tissue.	*Arthrodarin*
		*Diacerein*
		*Movagain*
*Polypreparations ( contain more than two active ingredients)*
	The active substances that make up this group of medications have a pronounced chondroprotective effect. Slow down degenerative processes in cartilage, improve trophism ( nutrition) cartilage tissue, and also to a certain extent accelerate the process of its regeneration.	*Artron complex*
		*Teraflex*
		*Artra*
		*Kondronova*

How do chondroprotectors work?

In essence, chondroprotectors are components of cartilage tissue or substances that improve metabolic processes in it and, to some extent, accelerate the restoration of cartilage due to the inhibition of certain enzymes ( hyaluronidase), increase elasticity, and also normalize trophism ( nutrition) cartilage tissue.

Chondroprotectors may include the following substances:

Glucosamine is one of the main components of cartilage tissue. Glucosamine, when taken systematically, enhances the production of proteoglycans ( complex proteins that form the amorphous substance of cartilage), as well as collagen fibers. Glucosamine protects the amorphous substance of cartilage from the damaging effects of free radicals ( extremely reactive oxygen compounds that can lead to disruption of permeability and destruction of cell walls). Glucosamine also improves metabolic processes in cartilage joint tissue. In addition, it has an analgesic and anti-inflammatory effect.
Chondroitin sulfate to some extent accelerates the formation of the main components of cartilage tissue ( hyaluronic acid, proteoglycans, glycosaminoglycans, collagen). Suppresses the enzyme hyaluronidase, excessive activity, which leads to the destruction of cartilage ( destroys hyaluronic acid, which is part of the amorphous substance of cartilage). Also has anti-inflammatory and analgesic ( painkillers) action.
Diacerein– a substance that has a pronounced anti-inflammatory and anti-edematous effect. Diacerein inhibits the production of biologically active substances that are involved in inflammatory reactions ( interleukin-1, interleukin-6, tumor necrosis factor). In addition, this substance improves the nutrition of cartilage by normalizing metabolic processes in it.
Mucopolysaccharide polyester of sulfuric acid contains chondroitinsulfuric acid, which is involved in the formation of the basic substance of cartilage tissue. This active substance inhibits the activity of hyaluronidase, which leads to inhibition of destruction ( destruction) cartilage tissue. It also enhances the production of intra-articular fluid.

For what diseases are chondroprotectors used?

Chondroprotectors are widely used for the treatment and prevention of various diseases of the joints and bones. These medications improve the trophism of cartilage, normalize metabolic processes in it, and also to some extent accelerate the process of its restoration. The greatest effect is achieved by chondroprotectors, which combine several active components at once ( glucosamine and chondroitin sulfate).

Pathologies for which chondroprotectors are used

Pathology	Name of the medicine
*Arthrosis of large joints* (damage to joints of a dystrophic nature, which occurs against the background of destruction of cartilage joint tissue).	Theraflex, Mucosat, Artrin, Structum, Chondrolon, Rumalon, Biartrin, Glucosamine, Elbona, Sustilak, Artron flex, Dona, Arteparon, Arthrodarin, Diacerein, Movagain, Artron complex.
*Osteocondritis of the spine* (degenerative disease of the spinal column, which primarily affects the intervertebral discs).	Teraflex, Mucosat, Artrin, Structum, Chondrolon, Rumalon, Biartrin, Glucosamine, Sustilak, Artron flex, Dona, Artron complex.
*Dorsalgia* (severe pain in the lumbar region).	Chondrogard, Mucosat, Artrin, Glucosamine, Diacerein, Movagain.
*Pseudoarthrosis* (fracture nonunion).	Chondrogard, Mucosat, Artrin, Artron flex.
*Osteoporosis* (a systemic disease in which there is a decrease in bone density).	Mukosat, Artrin.
*Chondromalacia patella* (damage to the articular cartilage of the patella).	Rumalon, Biartrin, Sustilak, Artron flex, Dona, Arteparon, Diacerein, Movagain.
*Meniscopathy* (damage to the meniscus of the knee joint).	Rumalon, Biartrin, Artron flex.
*Spondylosis* (a chronic disease of the spinal column that affects the intervertebral discs, as well as the ligaments that strengthen the spine).	Rumalon, Biartrin, Elbona, Sustilak, Dona, Artron complex.
*Arthritis* (inflammatory process in the joint)	Elbona, Artron flex.
*Humeroscapular periarthritis* (shoulder tendon inflammation).	Sustilak, Dona, Artron complex.

How are chondroprotectors used for arthrosis?

Most of the currently existing chondroprotectors are widely used in the treatment of arthrosis of the knee, hip, shoulder, elbow and other joints.

The use of chondroprotectors for arthrosis

Name of the medicine	Release form	Compound	Dosage	Duration of treatment
*Mucosat*	Solution for intramuscular administration, tablets, capsules	Sodium chondroitin sulfate	The medication is taken orally or administered intramuscularly. Orally ( inside) Adults are prescribed 0.75 grams twice daily for the first 3 weeks. In the future, the medication must be taken at a dose of 0.5 grams, also twice a day. A single dosage for children under one year is 0.25 grams, from 1 to 5 years – 0.5 grams, from 5 years – 0.75 grams. Capsules and tablets should be taken with a glass of water. The medication is administered intramuscularly every other day, 0.1 grams of the drug. From the 4th injection the dosage is doubled ( 0.2 grams).	Mucosate tablets should be taken twice a day for at least 4 to 5 weeks. The course of treatment when using the medication intramuscularly is 25–35 injections. If necessary, the course of treatment can be repeated again after six months.
*Artrin*	Ointment and gel for external use	Chondroitin sulfate	Apply externally to the skin over the lesion twice or thrice a day. The ointment or gel should be rubbed in for 2–3 minutes.	The course of treatment is 14–21 days. If necessary, the course of treatment can be repeated after a month.
*Chondrolone*		Chondroitin sulfate	100 mg) in one day. If the medication is well tolerated, starting from the fifth injection, a double dosage should be administered ( 200 mg).	The duration of treatment is, on average, 30 injections. On the recommendation of a doctor, the course of treatment should be repeated.
*Rumalon*	Solution for intramuscular injection	Glycosaminoglycan-peptide complex	On the first day, 0.3 milliliters of the medication is administered intramuscularly, on the second day - 0.5 ml and then 1 ml 3 times a week.	The duration of treatment is 5 – 6 weeks. The course of treatment can be repeated on the recommendation of a doctor.
*Glucosamine*	Powder for oral solution, tablets	Glucosamine	The contents of the sachet should be dissolved in 200 milliliters of water and taken once a day. Take 1 glucosamine tablet once a day with a glass of water.	The course of treatment is 5–6 weeks. If necessary, the course of treatment should be repeated after 2 or 3 months.
*Diacerein*	Capsules	Diacerein	Take 1 capsule in the evening with meals for the first 4 weeks, and then 2 capsules in the morning and evening.	The duration of treatment is usually 3 – 6 months.
*Artron flex*	Pills	Glucosamine hydrochloride	Take 1 – 2 tablets per day orally. For the first 2 weeks, it is recommended to take 2 tablets, followed by switching to 1 tablet per day.	Treatment should continue for 2 to 3 months.
*Don*	Powder for solution for oral administration, capsules, intramuscular injections	Glucosamine sulfate	1 sachet inside ( dissolved in a glass of water) 1 time per day. Capsules should be taken 1 - 2 pieces 3 times a day. Intramuscular injections must be administered every other day ( 3 times a week) 3 milliliters.	The course of treatment, depending on the form of release, ranges from 4 to 12 weeks.
*Arteparon*	Solution for the preparation of intramuscular injections	Mucopolysaccharide polyester of sulfuric acid	Inject slowly intramuscularly 1 milliliter twice a week. If the medication is administered inside the joint, a dosage of 0.5 - 0.75 milliliters is used, also 2 times a week.	The course of treatment is 5–6 weeks.
*Artron complex*		Chondroitin sulfate and glucosamine	Take 1 tablet one to three times a day. After the desired effect has been achieved, the medication can be taken 1 tablet once a day.	Treatment lasts 3 months. If necessary, the course can be repeated 1 or 2 times a year.
*Teraflex*	Capsules	Chondroitin sulfate and glucosamine	Orally, regardless of food intake, 1 capsule twice or thrice a day. Capsules should be taken with a small amount of liquid.	The course of treatment lasts 4 – 8 weeks. In some cases, the course of treatment can be repeated.

Which chondroprotectors are more effective in the treatment of arthrosis?

In modern practice, chondroprotectors are widely used to treat osteoarthritis. It is worth noting that currently single-agent drugs ( chondroprotectors of the first and second generation, which contain one active component) are used much less frequently, as they are considered to be not effective enough. Instead, combined chondroprotectors are increasingly being prescribed ( third generation), which combine several active substances at once.

Combined chondroprotectors may contain the following active substances:

Chondroitin sulfate, glucosamine and methylsulfonylmethane. The combination of glucosamine and chondroitin sulfate normalizes metabolic processes and accelerates the process of cartilage regeneration. Due to methylsulfonylmethane, the elasticity of cartilage tissue increases. This group of drugs includes Artron triactiv forte.
Chondroitin sulfate, glucosamine hydrochloride. These drugs are components of the amorphous substance of cartilage tissue. Chondroitin sulfate and glucosamine improve the trophism of cartilage, protect it from the damaging effects of free radicals, and also accelerate the process of regeneration of cartilage tissue. Representatives of this group are Teraflex, Artron complex and Chondroitin complex.
Chondroitin sulfate, glucosamine and non-steroidal anti-inflammatory drug ( ibuprofen or diclofenac). This group of drugs not only restores damaged cartilage tissue, but also has an analgesic and anti-inflammatory effect. This group of combined chondroprotectors includes Movex Active and Teraflex Advance.

The effect of taking these combined medications does not occur immediately, but within the first 2 to 4 weeks. The course of treatment is selected by the attending physician and depends on many parameters ( degree of joint deformation, age, presence or absence of severe pain, etc.).

New generation of chondroprotectors

Third generation chondroprotectors

Name of the medicine	Active substances	Therapeutic effect
*Teraflex*	Chondroitin sulfate, glucosamine hydrochloride	Chondroitin sulfate accelerates the synthesis of the main components of cartilage ( proteoglycans, collagen, hyaluronic acid). Significantly inhibits the activity of hyaluronidase, which can break down cartilage tissue. In addition, it has an analgesic and anti-inflammatory effect. In turn, glucosamine also accelerates the formation of some of the constituent components of cartilage ( proteoglycans and collagen). In addition, glucosamine protects the surface of cartilage from the damaging effects of free radicals.
*Artron complex*
*Chondroitin complex*
*Artra*
*Kondronova*
*Teraflex Advance*	Chondroitin sulfate, glucosamine and diclofenac/ibuprofen	In addition to glucosamine and chondroitin sulfate, it also contains a non-steroidal anti-inflammatory drug. Ibuprofen and diclofenac have a pronounced analgesic effect ( painkillers), anti-inflammatory and anti-edematous effect. They also eliminate morning stiffness in the joints to a certain extent.
*Movex Active*	Chondroitin sulfate, glucosamine and diclofenac/ibuprofen
*Artron triactive forte*	Chondroitin sulfate, glucosamine and methylsulfonylmethane	Methylsulfonylmethane has a pronounced anti-inflammatory effect. It also accelerates the process of regeneration of damaged cartilage cells and increases its elasticity.

What chondroprotectors should be taken to treat arthrosis of the knee joint?

For the treatment of arthrosis of the knee joint ( gonarthrosis) third generation chondroprotectors are widely used, which include several active components ( are multidrugs). The greatest therapeutic effect is observed from taking combination drugs. These medications contain not only cartilage components, which to a certain extent accelerate the restoration of cartilage joint tissue, but also non-steroidal anti-inflammatory drugs that have a local analgesic and anti-inflammatory effect.

Chondroprotectors for the treatment of arthrosis of the knee joint

Name of the medication	Release form	Compound	Mechanism of action	Application
*Artron complex*	Film-coated tablets	Chondroitin sulfate, glucosamine	Chondroitin sulfate is a component of normal cartilage tissue. This substance inhibits the activity of the enzyme hyaluronidase, excessive activity of which leads to the destruction of articular cartilage. It also reduces the rate of degenerative processes in cartilage and improves mobility in the knee joint. Glucosamine enhances collagen synthesis ( connective tissue proteins) and proteoglycans ( one of the main substances of cartilage tissue). Normalizes metabolic processes in the cartilage tissue of joints.	Take 1 tablet one to three times daily. After achieving the desired therapeutic effect, the medication can be taken 1 tablet once a day. The course of treatment lasts 3 months.
*Artra*	Pills			Take one tablet orally twice a day for the first 20 days. In the future, you should take 1 tablet 1 time per day.
*Kondronova*	Capsules, tablets			Take two capsules orally twice or thrice a day. The course of treatment is 1 – 2 months.
*Movex asset*	Pills	Chondroitin sulfate, glucosamine, diclofenac	In addition to the components of cartilage tissue, it also contains diclofenac potassium, which quite quickly eliminates acute or aching pain of an inflammatory nature. It is worth noting that all the components included in the medication have an analgesic and anti-inflammatory effect.	The tablets should be taken with a glass of water. For the first 20 days you should take 1 tablet three times a day ( regardless of food intake). In the future, the dosage is selected individually.
*Teraflex Advance*	Capsules	Chondroitin sulfate sodium, glucosamine, ibuprofen	In addition to chondroitin sulfate and glucosamine, it also contains ibuprofen, which has a pronounced anti-inflammatory, antipyretic and analgesic effect by blocking the cyclooxygenase enzyme ( COX-1 and COX-2).	Take 2 capsules orally three times a day immediately after meals with a glass of water. The course of treatment is selected individually.

What chondroprotective ointments exist and how to use them?

The use of chondroprotector ointments

Name of chondroprotector	Compound	Mechanism of action	Application
*Artrin*	Chondroitin sulfate	Helps slow down the degeneration of joint cartilage. Reduces the activity of the enzyme hyaluronidase, which promotes cartilage restoration. Normalizes the formation of synovial tissue ( articular) liquids. Leads to a decrease in the severity of pain in the joint, and also has an anti-inflammatory effect. To a certain extent improves the mobility of articular surfaces.	Rub into the skin over the affected joint 2 or 3 times a day. The course of treatment is 15–20 days.
*Chondroxide*	Chondroitin sulfate		Apply a thin layer to the skin twice or thrice a day. The course of treatment should be selected by the attending physician.
*Chondroitin*	Chondroitin sulfate, dimethyl sulfoxide	Dimethyl sulfoxide ( dimexide) enhances the effect of chondroitin sulfate, and also accelerates its penetration deep into the joint.	Rub into the skin over the affected joint twice or thrice daily. The course of treatment can range from 2 to 12 weeks.
*Chondroart*	Chondroitin sulfate, diclofenac, dimethyl sulfoxide	In addition to chondroitin sulfate and dimexide, it contains diclofenac, which has a pronounced anti-inflammatory and analgesic effect ( painkiller) action.	Apply twice or thrice a day to the skin of the affected joint. The course of treatment is selected individually.

It is worth noting that local forms of chondroprotectors are inferior in effectiveness to tablets and injections. The active components of the ointment partially penetrate into the joint cavity and act only locally, while other forms of release of chondroprotectors are capable of penetrating deep into the cartilage tissue of the joint through the blood and providing the necessary therapeutic effect.

What does Arthra chondroprotector contain and how to use it?

The drug "Arthra" is a combined chondroprotector of a new generation, which contains two active components at once ( glucosamine and chondroitin sulfate), which normalize metabolic processes in cartilage tissue, slow down its degradation, and improve trophism ( nutrition), and also have an anti-inflammatory effect.

The composition of the chondroprotector Artra includes the following active substances:

Glucosamine hydrochloride when used systematically, it enhances the synthesis of some components of cartilage tissue ( proteoglycans), as well as collagen fibers, which give strength to the articular surface. This substance is able to protect the surface of cartilage tissue from the negative effects of various chemicals. Glucosamine also improves the permeability of the joint capsule membrane and has a moderate anti-inflammatory and analgesic effect.
Chondroitin sulfate sodium is one of the main components of joint cartilage tissue. This substance enhances the production of hyaluronic acid, which allows cartilage tissue to gradually restore its structure. In addition, chondroitin sulfate inhibits the action of certain enzymes ( hyaluronidase), which thin the cartilage by reducing the amorphous substance. Chondroitin sulfate also has analgesic ( painkillers) and anti-inflammatory effect.

This chondroprotector is available in tablet form. The tablets have a biconvex oval shape and are coated. Children over 15 years of age, as well as adults, are prescribed 1 tablet twice a day for the first three weeks. In the future, you should take only 1 tablet once a day. You can take the tablets regardless of meals, washing them down with a small glass of water.

In rare cases, while taking Arthra tablets, adverse reactions from the gastrointestinal tract may occur ( upper stomach pain, bloating, diarrhea, or constipation). Sometimes allergic skin reactions are possible ( hives).

It is worth noting that the necessary therapeutic effect develops after 6 months of continuous use of these tablets.

What chondroprotectors should be taken for spinal osteochondrosis?

There are a number of chondroprotectors that are used to treat osteochondrosis of the spinal column. These medications promote the gradual restoration of cartilage tissue of the intervertebral discs, and also reduce the severity of pain.

Chondroprotectors for the treatment of spinal osteochondrosis

Name of chondroprotector	Compound	Mechanism of action	Application
*Mucosat*	Chondroitin sulfate	Slows down the degeneration of intervertebral discs. Reduces the activity of some enzymes ( hyaluronidase), which promotes the gradual restoration of cartilage tissue. Strengthens the synthesis of synovial ( articular) liquids. Reduces the severity of pain in the spine. Improves mobility of the entire spinal column. In addition, it has an anti-inflammatory effect.	Tablets should be taken 0.75 grams twice a day for the first three weeks of treatment and 0.5 grams also twice a day for the next 2 to 3 weeks. Injections are given every other day, 0.1 grams each. Starting from the 4th injection, the dosage is doubled ( 0.2 grams). The course of treatment is, on average, 25–35 injections.
*Chondrolone*	Chondroitin sulfate		1 ampoule is administered intramuscularly ( 100 mg) every other day. If the medication is well tolerated, starting from the fifth injection, double the dosage should be administered ( 200 mg each). The duration of treatment is usually 30 injections.
*Artron flex*	Glucosamine hydrochloride	It is a component of an amorphous substance ( main substance of cartilage) cartilage tissue. Glucosamine to a certain extent enhances the synthesis of proteoglycans ( complex proteins that form the amorphous substance of cartilage), as well as collagen fibers. It also protects cartilage tissue from the damaging effects of chemical factors. In addition, glucosamine has an anti-inflammatory and analgesic effect.	Tablets are taken orally, once or twice a day. For the first 15 days you should take 2 tablets per day, and then 1 tablet. The duration of treatment should be 2 – 3 months.
*Glucosamine*			The drug is available in powder form in sachets and tablets. The contents of the sachet must be dissolved in a glass of water ( 200 ml) and take once a day. The contents of the sachet should be dissolved in 200 milliliters of water and taken once a day. You need to take 1 tablet once a day. The course of treatment lasts, on average, 5 – 6 weeks.
*Don*			The medication is available in the form of intramuscular injections, capsules, and also in sachets. The contents of the sachet should be dissolved in a glass of water and taken once a day. Capsules should be taken 1 - 2 pieces up to three times a day. Intramuscular injections should be administered every other day ( 3 times a week) in a dosage of 3 milliliters. The duration of treatment, depending on the form of release, ranges from 1 to 4 months.
*Artron complex*	Glucosamine and chondroitin sulfate	Glucosamine and chondroitin sulfate in combination accelerate the process of cartilage tissue restoration ( pronounced chondroprotective effect), slow down degenerative processes in cartilage, and also improve trophism ( nutrition) cartilage tissue.	Take one tablet one to three times daily. After the desired therapeutic effect has been achieved, the drug should be taken 1 tablet once a day. Treatment lasts 3 months.
*Teraflex*	Glucosamine and chondroitin sulfate		Orally, regardless of food intake, 1 capsule twice or thrice a day. Capsules should be taken with a small amount of liquid. The course of treatment lasts 4 – 8 weeks. In some cases, the course of treatment can be repeated.

What natural chondroprotectors exist?

Some foods of plant or animal origin are extremely rich in substances that are involved in the formation of cartilage tissue in joints. That is why people with various pathologies of the musculoskeletal system ( osteoporosis, osteoarthrosis, spinal osteochondrosis) it is recommended to eat some natural chondroprotectors.

The following foods are rich in natural chondroprotectors:

rich broth from fish or meat;
stewed meat with joints;
aspic;
aspic from fish or meat;
avocado.

These foods contain hyaluronic acid, chondroitin sulfate or glucosamine. These substances are the main components of cartilage tissue.

Food products may contain the following chondroprotectors:

Hyaluronic acid improves metabolic processes in cartilage tissue, reduces the rate of degradation of articular surfaces, and is also a component of the intercellular substance of cartilage.
Glucosamine is one of the important components of the intercellular substance of cartilage. Glucosamine enhances collagen formation ( dense strands of connective tissue) and proteoglycans ( protein molecules that form the intercellular substance of cartilage tissue). In addition, this chondroprotector to a certain extent protects cartilage tissue from the negative effects of various chemicals. Glucosamine also has mild anti-inflammatory and analgesic properties ( painkillers) effect.
Chondroitin sulfate slows down degenerative processes in cartilage tissue by reducing hyaluronidase activity ( an enzyme produced by cartilage cells), which is capable of breaking down intercellular substance. Chondroitin sulfate enhances the formation of synovial fluid, due to which the cartilage receives more nutrients ( trophism improves). Also, this natural chondroprotector has good anti-inflammatory and analgesic effects.

Many degenerative diseases of the supporting apparatus are characterized by damage to cartilage tissue, which subsequently leads to severe pain and difficulty in mobility. In this case, doctors often prescribe chondroprotectors for joints to their patients. However, it is worth noting that the drugs are effective on initial stage diseases, at a late stage they will no longer have any effect.

What are chondroprotectors? Chondroprotectors are medications that act on the area where the problem is located. The active components help reduce the amount of effusion in the joint capsule.

It is worth noting that chondroprotectors are names that combine a diverse group of medications and biological additives. These medications promote the dynamic restoration and preservation of cartilage integrity. Of course, treatment takes a lot of time; a course of at least 2 months will be required. The constituent substances of chondroprotectors are chondroitin sulfate and glucosamine. The tablets also have auxiliary components: antioxidants, vitamins, minerals.

Are chondroprotectors effective? Taking the drugs helps reduce inflammation and normalizes the overall structure of porous cartilage tissue. As a result, the pain begins to subside. The peculiarity of these products is that they do not promote the development of new tissues, but the regeneration of old cartilage. But, the effective result will be if there is at least a small layer of cartilage in the damaged joint.

Medicines can be used together with analgesics. For changing pathologies of the musculoskeletal system, these tablets will provide an effective result only when the disease is in initial stage development.

Classification of drugs

The classification of chondroprotectors is divided by composition, generation, and method of application.

The first classification divides these drugs according to the time of their introduction into medicine and consists of 3 generations:

I generation (Alflutop, Rumalon, Mukartrin, Arteparon) - products of natural origin, consist of plant extracts, animal cartilage;
II generation – contains hyaluronic acid, chondroitin sulfate, glucosamine; Very good drugs issues pharmaceutical company Evalar;
III generation – combination remedy– chondroitin sulfate + hydrochloride.

Another chondroprotectors, their classification is divided into groups, depending on their composition:

medications whose main substance is chondroitin (Chondrolone, Chondrex, Mucosat, Structum);
mucopolysaccharides (Arteparon);
preparations consisting of natural extracts of animal cartilage (Alflutop, Rumalon);
preparations with glucosamine (Dona, Artron flex);
the best chondroprotectors complex impact(Teraflex, Artron complex, Formula-C).

There is also a classification, the essence of which is their release form:

injection chondroprotector drugs (Elbona, Chondrolon, Moltrex, Adgelon), these any injections are more effective than capsules, tablets, since they begin to act immediately; intramuscular injection is used; course of treatment – 10-20 days, 1 injection, then treatment with tablets continues;
capsules, tablets (Dona, Structum, Artra, Teraflex), their characteristic feature is that they begin to act only after 2-3 months, but after half a year an excellent result is observed; despite the fact that these drugs have been used for a long time, they are normally tolerated by the body and have virtually no side effects;
substitutes for the fluid present in the joint (Fermatron, Sinokrom, Ostenil, Sinvisk), they are used by direct injection into the joint; the course of treatment is usually 3-5 injections, but it happens that the desired result is already noticeable after the first injection; if necessary the need for re-treatment, then this is possible only in six months.

The list of chondroprotectors is quite diverse, so you don’t need to select them yourself. You should first visit a doctor, he will prescribe the correct medicine, since in each situation it is selected individually for each person.

Indications and contraindications

So, chondroprotective drugs can be used for the prevention and treatment of the following diseases:

cervical, thoracic, lumbar osteochondrosis;
periodontal disease;
traumatic joint disorders;
arthrosis (gonarthrosis, coxarthrosis);
periarthritis, arthritis;
postoperative period;
dystrophic damage in cartilage.

The use of these drugs is not always possible. There are the following contraindications:

pregnancy, during lactation;
allergic reaction on the components of the drug;
the last stage of dystrophic, degenerative diseases of the skeletal system;
children under 12 years of age.

Use natural chondroprotectors with caution in case of digestive system disorders.

Any medicine should only be used as directed by a physician. In order for chondroprotectors to have a beneficial effect on joints, they must be used on early stage development of the disease. The patient must comply with the following recommendations:

there is no need to put too much stress on the damaged joint;
a person should not be too fat; with a decrease in body weight, joint pain also decreases;
do not make movements that place stress on the damaged joint;
do not overcool the lower extremities;
carry out physical therapy;
do not forget about rest;
good for hiking.

Diseases for which it is used

The following pathologies can be treated with these drugs:

Osteochondrosis. To treat the disease, chondroprotectors are used for oral administration (Dona, Honda Evalar, Teraflex, Artra, etc.). They restore damaged cartilage tissue, remove painful sensations. In combination with other means, their effectiveness increases.
Arthritis. They use drugs (Chondroxid, Dona, Structum) along with anti-inflammatory and painkillers. Systematic treatment helps reduce swelling, pain, and joint stiffness. If large joints (knees) are damaged, intra-articular injections are used.
Arthrosis. Effective chondroprotectors for the treatment of arthrosis (Artron Flex, Dona, Honda Evalar, Alflutop) stimulate the production of intra-articular fluid and normalize its lubricating effects.
Coxarthrosis. It is better to choose medications that contain glucosamine and chondroitin sulfate (Teraflex, Chondroxide), they activate the renewal of cartilage and improve metabolism.

List of the most effective

What chondroprotectors can have an effective effect and how to choose? You can select a list of drugs that are most best medicines for therapy and restoration of joints:

How to use?

You can see the positive effect of using these drugs only when the therapeutic course is long (about six months at least).

You also need to know that in conjunction with these medications you need to use anti-inflammatory drugs, do massage, physiotherapy, follow a diet, and monitor your weight.

Numerous studies have confirmed the high safety of chondroprotectors when consuming the recommended dose. Side effects they have no other than possible allergic reactions. Drugs are excreted through the kidneys, regardless of the route of administration.

Sooner or later, it begins to bother many. Moreover, we learn about the problem when it has already reached a certain scale. Because pain means that changes in the cartilage have reached the first nerve endings. And they are located right along its edge! Usually at this moment a person tries to figure out what joints are and which ones to choose. Let's start with what do joints actually need?

What do joints need?

Without what will the joint not be healthy? Without good metabolism, for which our hormonal system is also responsible. And without full-fledged, since cell renewal requires a strict set of substances. And since they must be delivered to their destination on a regular basis, the third condition will be state of the vascular system. If there is no patency in the capillaries, then nutrition will not flow into the joint.

It should be noted that cartilage tissue is generally restored extremely slowly - there are few cells responsible for this - a tenth of all. In addition, with age, the production of hormones that stimulate regeneration also decreases.

Add to this poor nutrition and clogged capillaries. It turns out that the joints constantly do not receive what they need. That is, before you felt the first pain, they had already been openly “starving” for a long time!

Chondroprotectors for joints: a history of misconceptions

For a long time it was believed that joints could be helped by intensively feeding the body only with those substances that should make them strong. This gave impetus to widespread preparations based on collagen, chondroitin and glucosamine.

And everything seems logical: collagen provides strength and elasticity to fabrics, chondroitin saves water glucosamine is part of the synovial fluid that nourishes cartilage. Moreover, in similar drugs substances that are similar in structure to the human body are included, since they are extracted from cartilage, bones and skin of animals and are enzymatically broken down. However, despite this, hopes for effectiveness were in vain.

Over time, the bioavailability of chondroitin was studied. But even with its modern formula it did not exceed 2.5%. And many drugs based on it have shown results comparable to the placebo effect.

As a result, in 2007, the Formulary Committee of the Russian Academy of Medical Sciences classified chondroitin as a drug with unproven effectiveness. Glucosamine has not received FDA approval at all. food products and medicines.

Hope for such drugs finally faded with the advent of impressive studies proving their complete uselessness. As an example, we can cite the 2010 group of scientists S. Wandel, P. Jüni, B. Tendal and the 2012 group of scientists S. Colen, M. P. Vanden Bekerom, M. Mulier, D. Haverkamp and others.

It was previously assumed that glucosamine is important for the synthesis of cartilage tissue, and chondroitin was credited with the ability to inhibit the destruction of cartilage. However, all these hypotheses remained just hypotheses. In the end, scientists proved that in principle there can be no deficiency of these substances in the body. This means that the substances from these drugs do not provide anything. It is important for the body that it produces them in the ratio it needs.

After summarizing the available evidence, the Osteoarthritis Research Society International (OARSI) rated glucosamine and chondroitin as “unsuitable” for articular cartilage repair and “ambiguous” for pain relief. The organization recommended stopping taking these drugs if no improvement is observed within six months.

How to get rid of joint pain forever

It is clear that if generally accepted chondroprotectors for joints If they do not cope with their intended purpose, then the pain does not go away, because the processes of destruction of the joints continue. We numb the pain with non-steroidal anti-inflammatory drugs and glucocorticoids.

For a short time the pain disappears. And many people forget, and sometimes don’t even know, that sitting “on the needle” of such means means high probability earn or have a stroke. There is no need to prove this - instructions with a list are included in each package. Fortunately, the law obliges manufacturers to report the consequences of using their drugs.

Are we reading this? No, we simply cannot endure the pain every day and run to the nearest pharmacy.

But what to do?

Regeneration stimulants

It turns out that a real chondroprotector, that is, a protector of joints, can only be a remedy that can stimulate its own regeneration processes. And this is what will relieve pain.

Nature does not tolerate drastic external interference. Rather, she regards it as an intrusion. Therefore, let us pay attention to what she herself offers us - amazing plant, the roots of which have pronounced regenerating, restorative and chondroprotective effects. And that's why.

Dandelion contains about 10% taraxacin and taraxacerin. They are the ones stimulate factors on which the reproduction of cartilage cells depends. And this is important for restoring damaged areas.

Dandelion monoterpene glycosides have anti-inflammatory and antitumor effects. They influence the qualitative composition of synovial fluid, nourishing cartilage tissue. But the optimal volume of its production is influenced by amino sugar, of which up to 20% is found in dandelion roots.

Dandelion's natural sugars provide raw materials for collagen production. Let us emphasize: your collagen. The intercellular substance of cartilage consists of half of it! By the way, glucosamine, which is so necessary for joints, is also a representative of amino sugars.

It has been suggested that the elasticity of the articular joint may also be affected by rubber, also found in the plant.

In addition, dandelion contains nicotinic acid, promoting the active production of its own growth hormone. And it has a positive effect on joint regeneration. The fact is that after 25 years, its production by the body is reduced by half every 7 years.

To your own growth hormone the body, naturally, does not treat it as an invasion. But attempts to use the synthesized one were unsuccessful. About colossal adverse reaction warned endocrinologist Daniel Radman himself, who at one time proved positive influence somatotropin on the joints.

For a person who does not want oncology for himself, cardiovascular diseases or, drugs based on the synthetic hormone somatotropin are unlikely to be suitable, and by the way, they try not to use them in medicine.

But it is a fact that somatotropin is needed by joints. Only yours!

Speaking about dandelion, we should also mention inuline, which has a positive effect on the condition of the joints. There is 40% of it in the plant! It restores the balance of intestinal microflora and normalizes acidity.

This improves the absorption of magnesium, zinc and copper - minerals necessary for the complete regeneration of cartilage tissue. Not only cartilage, but also bone. Therefore, if you take osteoprotectors, since joint diseases in most cases go hand in hand with bone diseases, then the properties of dandelion will come in handy.

And most importantly: you can forget about taking painkillers and anti-inflammatory drugs. Dandelion contains the inflammation-suppressing triterpene compound arnidiol, and its essential oils promote pain relief.

Everything together makes this plant the most valuable and effective for helping joints. Of course, each person is individual, but in most cases, after one and a half to two months, many feel global improvements and relief from pain. Note that healing joints with dandelion root is possible without a long list of side effects, which none of us really wants to face.

Elastic vessels = your longevity

Let us remember that so valuable substances Dandelion roots are transported to the joints through blood vessels. Therefore, we need to help them first of all!

An excellent substance from larch copes with this once or twice. This is the reference antioxidant! At the same time, it will help your heart. Inelasticity of blood vessels is a common cause of heart disease and stroke.

Dihydroquercetin stimulates blood circulation, tones blood vessels and makes them elastic. It eliminates spasms, reduces blood viscosity and regulates blood cholesterol levels.

By the way, about cholesterol. Many people have heard that the level of “bad” cholesterol should be reduced. But they don’t know that atherosclerosis often develops in people with normal level cholesterol.

Here you need to understand that this connection is vital for humans. Only a fifth of cholesterol comes to us with food, but the body produces 80% itself! Most of it is found in the brain, and with its deficiency, the brain function, up to Alzheimer's disease.

Cholesterol is needed by cells, it is part of the biosynthesis of many hormones and is responsible for the production of so important!

The use of statin drugs to lower cholesterol levels today is controversial. There is an opinion that cholesterol accumulates in places of microdamage to blood vessels as a “repair” material, ensuring their functionality. Therefore, simply reducing its level does not in itself solve all problems with blood vessels. And its deficiency causes hemorrhages.

Therefore, the antioxidant dihydroquercetin, regulating cholesterol to individual norm each person and increases the elasticity of blood vessels, - ideal for safe and effective assistance them.

If dihydroquercetin is combined with nutrition for cells, as is done in Apitonus P, then such a drug acts simultaneously in two directions: it helps blood vessels and delivers nutrition.

Unlike Dihydroquercetin Plus, Apitonus P also contains royal jelly bees are the only such highly nutritious product in the world, rich in amino acids, microelements, proteins and fats.

Scientists also discovered in it gonadotropic hormones regulating the functioning of the sex glands. By value for milk can only be compared with.

Summarizing the above, it should be said that to be effective, taking Dandelion P should be combined with Dihydroquercetin Plus or Apitonus P.

Ideally, only Thyreo-Vit, a preparation based on white cinquefoil, kelp and echinacea, can be added to this tandem. Cinquefoil is widely known for its ability to regulate the functioning of the thyroid gland, helping the body stimulate regeneration processes. Namely, it produces the hormones calcitonin and parathyroid hormone, which are necessary for the health of bones and joints.

Laminaria is a source of natural iodine. Echinacea It will also boost the immune system, maximizing the overall result.

Why Parapharm drugs are preferable!

Parapharm fundamentally does not produce drugs based on extracts.

Firstly, up to 5% of production substances - acetone or aluminum salts - always remain in the extract. Who wants to take acetone medicinal purposes? The answer is obvious.

Secondly, during extraction, the plant material is heated. And when heated, the plant loses some of its active substances. It is not a fact that the very compounds that make the plant useful to humans will not disappear.

For example, it was long believed that in calendula The main active ingredient is rutin. That is, extract manufacturers made sure that it was present in the final product.

However, relatively recently, the leading Russian scientist in the field of pharmacognosy, Professor Vladimir Kurkin, experimentally proved that a completely different substance, narcissin, is responsible for the main therapeutic effect in calendula. This is why it is important to use the whole plant. A person has studied them as a whole, but does not know the actions of all their components.

Dear friends, hello!

After a short break, we return to talking about drugs, and today's conversation will focus on a group that causes a lot of controversy. We will talk about chondroprotectors.

I've been studying this issue for the past week and have come to the conclusion that modern drugs chondroprotectors are still a “dark horse”.

But one thing is clear: the entire people are divided into 2 camps in relation to this group. Moreover, everyone shares:

Doctors. Some consider chondroprotectors to be the main pathogenetic treatment for arthrosis. Others say it's clean water profanation. The latter, in particular, includes your dearly “beloved” Elena Malysheva, who from a large podium, or rather, directly from TV, reported that chondroprotectors are drugs with unproven effectiveness.
Pharmacy employees. Alone, having read publications and clinical trials, think the same as a TV star. Others claim that chondroprotective drugs really “work”. Firstly, grateful customers say this, secondly, “I took it myself, it became easier,” thirdly, “I gave it to my mother,” there is an effect.”
Sufferers who know what it is like firsthand. Some write reviews like: “I drank, no use. I just threw away my money in vain.” Others retort to them: “but it helped me!”

After studying and understanding videos, clinical studies and doctors’ opinions, I formed MY OWN opinion.

CHONDROPROTECTIVE DRUGS WORK, unless...

Although no, we won’t run ahead of the locomotive.

I feel now how happy the supporters of this group were, and how its opponents frowned, dreaming of throwing rotten tomatoes at me.

Do not order execution, order the word to be spoken!

Moreover, it is in your own interests to love this group of products: otherwise how are you going to sell them?

Now we will look at the following questions:

Why don’t chondroprotectors always help?
How are they divided?
Why do they have side effects?
Which is better: a single drug or a combination drug?
What are the features and “tricks” of popular chondroprotectors?

But first, as usual, let’s remember how a joint is structured in our body and how it works.

How is the joint structured?

So, a joint is a connection of the articular surfaces of bones, each of which is covered with cartilage.

The joint is enclosed in an articular capsule, or capsule, which is attached to the articulating bones. It ensures the tightness of the joint and protects it from damage.

Joint cartilage is a kind of lining necessary for the smooth sliding of the heads of bones relative to each other and for cushioning the loads that the joint experiences during movements.

Between the heads of the bones there is a slit-like space - the joint cavity.

The inner lining of the joint capsule is called synovial and produces synovial fluid into the joint cavity.

Synovial fluid is needed to lubricate the articular surfaces of the bones, so that the cartilage does not dry out, and so that all the functions of the “ship” work normally.

Cartilage in its structure resembles a sponge: when loaded into the joint cavity, synovial fluid is released from it, and as soon as the compression stops, the fluid returns back to the cartilage.

What does joint cartilage consist of?

The basis of cartilage is made up of collagen fibers that go into different directions, forming a grid. The cells of the “mesh” contain proteoglycan molecules that retain water in the joint. Therefore, cartilage contains approximately 70-80% water.

Proteoglycans consist of protein and glycosaminoglycans.

Glycosaminoglycans are carbohydrates, which include hyaluronic acid and chondroitin sulfate, among others. Look at the picture above: chondroitin is the “brush” hairs in proteoglycans.

Both require glucosamine to produce. It is formed by cartilage tissue cells, chondrocytes, from substances that enter the body with food.

That is, glucosamine is a building material for chondroitin. And chondroitin is needed for the synthesis of hyaluronic acid.

What is synovial fluid?

It is a filtrate of blood plasma, which contains hyaluronic acid, outdated joint cells, electrolytes, and proteolytic enzymes that destroy old proteins.

Hyaluronic acid binds and retains water in the joint cavity, due to which the synovial fluid moisturizes the articular surfaces of the bones, and they move relative to each other like clockwork.

And one more important point. The fluid in the joint cavity does not stand like in a swamp.

It circulates. Old cells die, new ones are born, the blood plasma filtrate is renewed, and for this process, like air, movement is necessary.

How is the joint “nourished”?

The nutrition of the joint leaves much to be desired.

It does not have its own blood supply.

Its “nurse” is the synovial fluid, from where the cartilage, through osmosis, that is, seepage, takes the nutrients it needs. And they enter the synovial fluid from the blood vessels passing next to the joint.

But even here, not everything is so simple.

The cartilage absorbs synovial fluid only when it moves: when the leg is bent, synovial fluid comes out of the cartilage into the joint cavity, when it is straightened, it goes back into the cartilage, delivering the necessary “food” to it.

In addition, when moving, the muscles attached to the elements of the joint contract, and due to this, blood is pumped through their vessels, delivering more nutrients to the cartilage.

A little more about chondrocytes

Chondrocytes are responsible for the restoration and production of substances necessary for cartilage. But the whole problem is that there are very few of them: only 5%, and the rest (95%) is cartilage matrix (collagen fibers).

In addition, among chondrocytes there are young, mature and aged cells. The parade is commanded, of course, by the mature ones. Others either STILL do not have enough strength to synthesize the substances necessary for cartilage, or ALREADY do not have enough.

But with adequate loads and normal nutrition of the joint, this is enough.

conclusions

Thus, for normal joint function you need:

Mature chondrocytes receiving adequate nutrition.
Normal blood supply to the joint.
Adequate functioning of the muscles surrounding the joint.

Why does arthrosis develop?

Most often it develops as a result of one of four problems.

Or they OVERLOADED the joint ( overweight or sports loads, which exceed the ability of cartilage to extinguish them).
Or they UNDERLOADED it (hypodynamia, as a result of which the blood supply to the joint is disrupted, the cartilage does not receive adequate nutrition and begins to collapse).
Or all together (+ physical inactivity).
Or a serious injury that disrupts the metabolism in the joint and its nutrition.

What happens in the joint under the influence of these factors?

Chondrocytes do not have time (if overloaded) or cannot (if underloaded) form sufficient quantity glucosamine.
If there is no glucosamine, chondroitin is not formed.
If chondroitin is not formed, hyaluronic acid is not formed.
If hyaluronic acid is not formed, fluid is not retained in the joint.
If there is little fluid in the joint, the articular heads of the bones are not moisturized.

And then this happens:

Stages of arthrosis

Stage 1 arthrosis:

Cartilage loses water, i.e. dries out.
Collagen fibers are torn or destroyed completely.
The cartilage becomes dry, rough and cracks.
Instead of sliding unhindered, the cartilage of the articulating bones “clings” to each other.

Stage 2 arthrosis:

The pressure on the bone increases.
The heads of the bones begin to gradually flatten.
The cartilage becomes thinner.
The joint gap decreases.
The joint capsule and synovial membrane “shrink”
Bone outgrowths – osteophytes – appear along the edges of the bones.

Stage 3 arthrosis:

The cartilage disappears completely in some places.
The bones begin to rub against each other.
The joint deformity increases.

Stage 4 arthrosis:

The cartilage is completely destroyed.
The joint space is practically absent.
The articular surfaces are exposed.
The deformation of the joint reaches its maximum.
Movement is impossible.

As a result of these changes, inflammation develops in the joint. It becomes swollen and intensifies.

Now let's move directly to the drugs.

But first, a few basic points.

When do chondroprotectors “work”?

First of all, let's be clear about the following:

Chondroitin and glucosamine are effective on Stages 1-2 of arthrosis, when there is no destruction of cartilage yet, and chondrocytes are alive.
Chondroitin sulfate is a large molecule, approximately 100 times larger than glucosamine, so its bioavailability is only 13%.
The bioavailability of glucosamine is greater, but also not much, only 25%. That is, 25% of the dose taken will reach the joint directly.
Optimal therapeutic dosages chondroprotectors for oral administration, according to practicing doctors, are as follows:

To get real results you need 2-3 courses of treatment with these drugs, which will take up to 1.5 years.
Practitioners advise taking chondroprotectors for 3-5 months in a row and repeating the course every six months.
Chondroprotectors should be taken regularly, in courses, and not from case to case.
There is no point in taking chondroprotective drugs if you continue to abuse the joint excessive loads. To achieve the effect, you need to lose weight, and athletes need to give up regular training.
You can take this group for a very long time and not see results if you don’t provide normal nutrition joint. This requires special (!) exercises.
For the production of chondroitin and glucosamine, cattle cartilage and extracts from sea fish. It is difficult to achieve 100% purification, so when taking these drugs allergic reactions occur and gastrointestinal problems (abdominal pain, diarrhea, constipation, etc.)
Chondroitin sulfate reduces clotting blood, so it cannot be used together with anticoagulants and if there is a tendency to bleeding.

contraindicated

Diabetics need to monitor their sugar levels especially carefully when taking these medications. It may increase (carbohydrates, after all).

How do chondroprotectors work?

What does glucosamine do?

Stimulates the activity of chondrocytes.
Necessary for the synthesis of chondroitin sulfate and hyaluronic acid.
Prevents the destructive effect of NSAIDs and glucocorticosteroids on cartilage.

What does chondroitin sulfate do?

Necessary for the synthesis of hyaluronic acid.
Normalizes the production of synovial fluid.
Reduces the activity of enzymes that damage cartilage.
Has an anti-inflammatory effect.

Types of chondroprotectors

Let's look at how chondroprotectors are divided.

By method of administration exist:

Preparations for oral administration (Structum, Dona powders and tablets, Artra, etc.)
Preparations for injections (Dona r/r, Alflutop, Rumalon, etc.)
Preparations for external use (Chondroxide, Chondroitin, etc.).

At parenteral administration the bioavailability of chondroprotectors is significantly higher, so they are prescribed when it is necessary to quickly relieve an exacerbation, or when the patient prefers short courses of treatment, or when there are problems with the liver, so as not to burden it.

Preparations for external use are effective only in combination with other forms of release.

Based on their composition, chondroprotectors are divided into:

Monopreparations that contain only chondroitin sulfate (CS) or glucosamine (GA): Structum, Dona.
Combined products containing both components: Artra, Teraflex.
Products that, in addition to cholesterol and GA, contain a non-steroidal (i.e. non-hormonal) anti-inflammatory agent: Teraflex Advance.

With the latter, everything is clear: if there are signs of inflammation (severe pain, swelling), we first recommend a drug with NSAIDs. After 2-3 weeks, you can switch to a “pure” chondroprotector.

As for the first two, there is no clear answer to the question “which is better”. Some doctors prefer single drugs, others combine them, and still others prescribe both, depending on the situation.

But I noticed that glucosamine gives more side effects from the gastrointestinal tract.

Therefore, the combination of GA and cholesterol seems to me to be the most optimal: it increases the bioavailability of the drug and reduces the frequency of adverse reactions.

Well, now let's go over the drugs.

I'll start with the "oldies":

RUMALON– solution for intramuscular administration.

Compound:

Glycosaminoglycan-peptide complex obtained from cartilage and bone marrow of calves (a powerful allergen due to animal proteins).

What is he doing:

Improves the synthesis of cholesterol, promotes the maturation of chondrocytes, stimulates the synthesis of collagen and proteoglycans. Moreover, the manufacturer writes that the drug is effective both in early and late late stages arthrosis. The latter makes me doubtful.

Application: administered according to the scheme for 5-6 weeks 2 times a year.

Side effects: allergic reactions.

ALFLUTOP- injection.

Ingredients: bioactive concentrate from small sea fish.

Contains amino acids, mucopolysaccharides, and microelements that are beneficial for cartilage: sodium, magnesium, zinc, iron, etc.

What it does: inhibits the activity of hyaluronidase, an enzyme that destroys hyaluronic acid. So the latter becomes larger, and the condition of the cartilage improves.

Application:

There are 2 schemes for its use:

Intramuscularly daily, 1 ml for 20 days.
Intra-articularly, 1 or 2 ml per joint every 3-4 days. Only 5-6 injections.

The course is repeated after six months.

Sometimes doctors start with intra-articular injections, then switch to intramuscular ones. It depends on the doctor. How many doctors, so many techniques.

Contraindications: allergy to seafood (can be very severe).

CHONDROLON— lyophilisate (i.e. the active substance is in a dried state) for preparing a solution

Composition: contains chondroitin sulfate 100 mg per ampoule.

Since bioavailability with this administration is high, this dosage is sufficient.

It is obtained from the cartilage of the trachea of cattle.

What it does: suppresses the activity of enzymes that cause cartilage destruction, stimulates the production of glycosaminoglycans by chondrocytes, normalizes the production of synovial fluid, and has an anti-inflammatory effect.

Application: 1-2 ampoule intramuscularly every other day. A total of 25-30 injections. The course is repeated after six months.

DONA– single drug.

Ingredients: contains glucosamine sulfate.

What it does: stimulates the synthesis of hyaluronic acid and other glycosaminoglycans, inhibits enzymes that cause cartilage destruction.

In one tablet 750 mg GA.

How to take: 1 t. 2 times a day with meals. Improvement occurs after 2-3 weeks. Minimum course 4-6 weeks. Repeat the course after 2 months.

The powder contains 1500 mg of GA.

For whom is it optimal? this form of release: powders are especially good for working citizens, for whom it is more convenient to take the drug only once a day.

And also for those who have difficulty swallowing pills.

Application: the powder is dissolved in a glass of water and taken once a day (also better with meals). The course is 6 weeks, repeated after 2 months.

Solution for intramuscular administration: 1 ampoule contains 400 mg of glucosamine. Bioavailability 95%. In addition to glucosamine, it contains lidocaine, so it has many contraindications: cardiovascular failure, impaired liver and kidney function, epileptic-type seizures, etc. There are many side effects.

Medical prescription only!

Application: Administer 3 times a week for 4-6 weeks. And then as the doctor decides. Maybe he’ll switch to powders or tablets.

STRUCTUM– capsules.

Ingredients: contains chondroitin sulfate.

Available in 250 mg and 500 mg doses. Honestly, I don’t know why the first release form exists, since the manufacturer recommends taking 500 mg 2 times a day.

Judging by the availability in Moscow pharmacies, Structum 250 mg is flying off the shelves. Maybe I'm wrong.

What is he doing? Stimulates the synthesis of glycosaminoglycans, improves exchange process in cartilage.

Application: take it 500 mg 2 times a day for 6 months.

The effect after cancellation lasts 3-5 months, then you need to repeat the course.

– a combined remedy.

Composition: contains very adequate dosages of chondroitin and glucosamine: 500 mg each

What it does: all the good things that GA and CS do in the joint.

Application: take this drug 1 t. 2 times a day for the first 3 weeks, then 1 t. per day for a long time, but not less than 6 months.

TERAFFLEX ADVANCE - another combination drug.

Composition: it contains: GA 250 mg, CS 200 mg and ibuprofen 100 mg.

So besides everyone beneficial effects the first two substances also have an anti-inflammatory and analgesic effect.

In addition to all the beneficial effects of the first two substances, it also has an anti-inflammatory and analgesic effect.

True, there are several times more contraindications and side effects due to ibuprofen.

Application: take 2 capsules 3 times a day after meals for no more than 3 weeks. Then they switch to regular Teraflex.

TERAFLEX

Composition: contains GA 500 mg, cholesterol 400 mg.

Application: take it for the first 3 weeks, 1 capsule 3 times a day, then 1 capsule 2 times a day for 3-6 months, preferably with meals. Then, as usual, the courses are repeated.

External chondroprotectors

I will focus only on the most popular drug, Chondroxide.

CHONDROXIDE

Composition: contains 50 mg of chondroitin sulfate per 1 g.

Release forms: ointment and gel.

Application:

A large molecule of chondroitin cannot penetrate the skin on its own, so in order to transport it through cell membranes, dimexide is added to the drug, which also has an anti-inflammatory and analgesic effect.

Do not apply to open wounds.

CHONDROXIDE FORTE - cream

Composition: contains cholesterol and the anti-inflammatory substance Meloxicam, that is, it reduces inflammation and pain.

Contraindications standard for NSAIDs.

Given this composition, it is better not to recommend it to the elderly. There is a gel for them during periods of exacerbation.

This is not just a cream, it is a transdermal glucosamine complex (glucosamine + triglycerides).

Compound . contains glucosamine, and not chondroitin, like the previous forms, and dimexide, so we recommend it when an allergic reaction to other external forms of chondroxide was noted in the past.

And also when the buyer does not care about the high price. The main thing is that the effect is maximum.

The active substance is enclosed in a shell of lipids, which together forms a micelle (nanoparticle) that delivers the active substance to the joint in a concentration comparable to an injection.

Application: apply it 2-3 times a day for 3-4 weeks. If necessary, the course is repeated.

I end with this.

You have a lot of chondroprotectors in your assortment: both drugs and dietary supplements.

But knowing the basic things I talked about, you can now independently understand the composition of such a product and its effectiveness.

I hope that now you can easily continue the phrase:

CHONDROPROTECTORS WORK, unless...

And as a homework I suggest you think:

What questions should a buyer ask when choosing a chondroprotector?

Having studied everything thoroughly, I understood why in some countries all chondroprotectors are considered additives: because their bioavailability is low (and the manufacturers, by the way, do not hide this), and the therapeutic effect is greatly delayed in time.

And in conclusion, I will answer the most common question:

Why are there so many bad results from using chondroprotectors?

Because, as usual, people hope for a magic pill without putting in the effort to lose weight and work muscles.
Because they want quick results, and, without seeing them, they stop treatment.
Because they start “drinking Borjomi when the kidneys fail,” i.e. take chondroprotectors at stages 3-4 of arthrosis.

That's all.

How did you like this article, friends?

What do YOU think about chondroprotectors?

Add, comment, share your experience, click on the social buttons. networks.

See you again on the blog for hard workers!

With love to you, Marina Kuznetsova