A 2009 Cochrane review of 25 studies with a total of 4963 patients with OA reported that 1500 mg of glucosamine daily had an excellent safety profile, reduced pain by 22%,
and improved function by 11%, resulting in no detectable difference in efficacy compared with NSAIDs.84 Additionally, 2 studies provided “high-quality” evidence for a small increase in minimum joint width at a mean 3 years of follow-up.59,64 When only the best studies were included in the analysis,
no benefits were demonstrated.84 Selective meta-analyses of chondroitin or the combination of the 2 supplements have reported similar conclusions, demonstrating no overall benefit in pain reduction or maintenance of joint space for knee OA. Industry-independent studies have consistently demonstrated less beneficial effects than industry-funded trials.65,87 Based on these findings, the American Academy of Orthopaedic Surgeons currently recommends against prescribing glucosamine and chondroitin for knee OA.