Synonyms in a broader sense
- Cartilage-forming substances
- Cartilage formation
- Hyaluronic acid
- Cartilage formation
- Cartilage protection substances
The manufacturers of chondroprotective agents listed below are exemplary, other suppliers may have been forgotten. – Synvisc®
- Suplasyn®
- Ostenil®
- Hyalart®
- Durolane®
- Go on®
- Hya-GAG®
- Orthovisc®
- Fermathron®
- Hya Ject®
- Hyalubrix®
- Amongst other things
Definition
Chondroprotectives are cartilage protection agents which – according to the manufacturer – are intended to stop the destruction of cartilage. The chondroprotectives are supposed to inhibit cartilage degrading substances and rebuild cartilage. In addition, the chondroprotectives are said to have an anti-inflammatory effect.
The effect of these drugs is scientifically assessed differently. Many patients, however, express a significant reduction in the sensation of pain, which has been proven by studies. These chondroprotective drugs certainly cannot achieve a cartilage build-up, as is sometimes described in advertising.
Effect
The effect of the chondroprotective agents has been proven by clinical studies, which show a reduction in pain and swelling and confirm an improvement in joint mobility. The highest efficacy rate of chondroprotective agents is expected when hyaluronic acid is injected directly into large joints such as the knee joint, hip joint or ankle joint. But also small joints such as the finger joint or facet joint of the spine benefit from targeted infiltrations.
The effectiveness varies greatly from individual to individual. The duration of effectiveness also varies considerably. An improvement in the range of months up to several years is realistic.
The duration of effectiveness of the chondroprotectives depends decisively on the stage of the arthrosis. – superficial cartilage layer
- Middle cartilage layer
- Calcifying cartilage layer
- Bones
Chondroprotectives consist mainly of hyaluronic acid and glucosamine. Glucosamine is a highly concentrated amino sugar, which is of vital importance as a basic building material for cartilage, tendons, ligaments and bone structures, as well as for connective tissue, artery walls and the skin.
It is also used to repair and rebuild cartilage in the joints, the spine, and to form bones by means of so-called “chondral ossification“. Glucosamines are synthesized directly from food by a healthy and young organism. With increasing age, however, the organism loses the ability to synthesise (= produce) from food.
This is intensified by the fact that our modern diet usually does not offer any food containing these substances. Cartilage and connective tissue parts, for example, are on the menu of very few people today. Glucosamine serves as “hyaluronic acid” (special form of glucosamine) for the formation of synovial fluid, the so-called “synovial fluid”.
Hyaluronic acid as a chondroprotective agent is found, for example, in skin and bone tissue, in the vitreous body of the eye and in the umbilical cord of unborn children. Chondroprotective agents are called “intercellular cementing substance” and are considered to be an important component of the basic substance of connective tissue. If the body lacks insulin and/or corticoids (cortisone), the body’s own production of hyaluronic acid is partially or completely disturbed.
As a direct consequence of a deficiency of these chondroprotective substances resulting from these circumstances, the synovial fluid, which is viscous in itself, becomes thin and watery, and the cartilage of the joint capsules also shrinks and becomes brittle. This ultimately leads to erosion of the cartilage layers in the joints, causing inflammation, swelling, stiffness and pain. Glucosamine and hyaluronic acid as chondroprotectives belong to the mucopolysaccharides.
They are also called “glycosaminoglycans”. One of them is chondroitin, another sugar compound with a giant molecular structure and the main component of all cartilage, which is produced from glucosamine. As the glucosamine molecule is about 250 times smaller than chondroitin, it can be better absorbed in the digestive tract and thus be supplied to the organism more quickly.
The bio-active form of both chondroitin and glucosamine is chondroitin sulphate and glucosamine sulphate respectively. Only when combined with the salt of sulphuric acid does it form substances (chondroprotectives) that can be absorbed and utilised by the organism. Living matter, such as cartilage, ligaments, tendons and connective tissue are in principle capable of regeneration.
The connective tissue substance is of particular importance in this respect, as it is present in all ligaments, tendons and blood vessels. It is the basic substance of the entire skeleton, of most organs and connects both with each other and with the surrounding body tissue. However, the prerequisite for the regenerative ability of living matter is that the necessary materials are available in sufficient quantities.
The most important building materials of chondroprotective agents are the above-mentioned glycosaminoglycans: hyaluronic acid, glucsoamine and chondroitin. They ensure that the above-mentioned tissues are continuously built up and broken down (=transformed). In the cartilage, a special form of “compressed” connective tissue, the cells are anchored in a compact and solid basic substance (= matrix).
Cartilage is part of the skeletal structure and consists mainly of the glycosaminoglycans mentioned above. However, it also contains a high proportion of water and collagen. The main problem with the regeneration of cartilage, however, is that it is not supplied with blood and the necessary building material can only be transported to the cartilage cells with difficulty.
If the supply of glucosaminoglycans to the cartilage cells is not guaranteed, they lose their ability to store fluid and absorb nutrients. The cells dry out, shrink and eventually die. This then leads to cartilage erosion (wear) and the associated symptoms.
Chondroitin sulphate binds most of the water in the connective tissue, giving it its elasticity and shock-absorbing properties. The water binding of the chondroprotective substances is effected by an electrical charge, with the help of which a viscous mass of gelatinous material is formed, which both binds the tissue cells together and lubricates the bursae and joints. In addition to chondroitin sulphate, this viscous mass contains a high proportion of hyaluronic acid. The chondroitin sulphate is partly absorbed through food and partly produced from glucosamine sulphate by the body itself. When exposed to vitamin C, chondroitin sulphate also controls the production and stabilisation of collagen, a fibrous protein that is also required for the internal binding of connective tissue and cartilage substance.
