1. Definition: Degenerative joint disease (D.J.D.) or Osteoarthritis is a degeneration of the joint surface resulting from wear and tear over many years. This process usually manifests itself after age 50, however, it may begin sooner if there is a history of injury to the joint. The cartilage surfaces, known as articular or hyaline cartilage, deteriorate by softening fissuring, fragmenting and finally dissolving away. The underlying exposed bone is then subjected to greatly increased stress resulting in pain, swelling and gradual loss of joint function.

2. Treatment: Traditional drug therapy for D.J.D. of the knee has focused on the use of oral nonsteroidal anti-inflammatory medications…Naprosyn, Feldene and Motrin to name a few. These agents have a significant incidence of stomach irritation and even ulceration and are only capable of treating the symptoms…not the disease. Cortisone and it's synthetic derivatives have been used by direct injection into the knee joint for decades with good relief of symptoms but, again, allow the disease to progress unabated.

Glucosamine and Chondroitin Sulfate(Cosamin DS)
are chemicals found in human articular cartilage.
Recently, these compounds have been made
available for the treatment of D.J.D. When taken
in the proper oral combination, these “neutraceuticals”
 can decrease pain and improve joint function in cases
of mild to moderate osteoarthritis. Glucosamine is a
building block used in hyaline cartilage synthesis, while Chondroitin Sulfate inhibits cartilage breakdown. Taken together, these chemicals are far more effective than either one taken alone. Most commercially available brands contain 500 mg. of Glucosamine and 400 mg. of Chondroitin Sulfate in oral form. Dosing varies with the patient's weight, symptoms and duration of treatment. 4 to 8 weeks of treatment is usually necessary before relief of symptoms is noticed. There have been no significant side effects reported to date. These products are available without a prescription and can be obtained at most pharmacies and health food stores. Patient's should consult their physician before and during treatment.

Hyaluronic Acid is a chemical that is found in human synovial fluid and hyaline cartilage. Recently, this compound has been made available in injectible form for the treatment of mild to moderate osteoarthritis of the knee. It is derived from rooster combs and processed into a
                                                          liquid that is quite viscous. This is injected into the knee joint
                                                          and is believed to work by increasing the viscosity of the
                                                          synovial fluid in the knee as well as by promoting cartilage
                                                          synthesis. The injections are given once every week for 3 to
                                                          5 weeks after which patient's will begin to experience relief
                                                          of symptoms. Pain relief and improvement of joint function 
                                                          can last up to 1 year after treatment is completed. Side
                                                          effects include local pain and swelling at the injection site.
                                                          This medication is only available by prescription and should
                                                          only be administered by a physician or physicians assistant
                                                          experienced in giving intra-articular injections.

In the last decade, research in the field of D.J.D. has begun to focus on restoring the damaged articular cartilage. Several of these “cartilage supplements” are now available in oral and injectible form.