***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The main aim of this study was to examine the effects of 4 weeks of glucosamine administration on the functional ability and the degree of pain intensity in competitive male athletes after acute knee injury . This study was a r and omized , double-blind parallel trial of glucosamine ( 1500 mg per day ) or a placebo for 28 days , utilising 106 patients with an acute knee injury .  Pain and functional ability were evaluated at the beginning of the study and at 7 , 14 , 21 , and 28 days after starting treatment . Pain intensity at rest and while walking was assessed using a visual analog scale . Passive knee flexibility ( flexion and extension ) of the injured limb was measured using a modified goniometer , and the degree of knee swelling was measured and compared with the noninjured limb . No significant difference was found between the glucosamine , and placebo group in mean pain intensity scores for resting and walking , and degree of knee swelling at the 7-day , 14-day , 21-day , and 28-day assessment . There was no significant difference between passive knee flexibility at the 7-day , 14-day , and 21-day assessment . After 28 days of treatment the patients from the glucosamine group demonstrated significant improvement in knee flexion and extension as compared with the placebo group BACKGROUND Glucosamine and chondroitin sulfate are used to treat osteoarthritis . The multicenter , double-blind , placebo- and celecoxib-controlled Glucosamine/chondroitin Arthritis Intervention Trial ( GAIT ) evaluated their efficacy and safety as a treatment for knee pain from osteoarthritis . METHODS We r and omly assigned 1583 patients with symptomatic knee osteoarthritis to receive 1500 mg of glucosamine daily , 1200 mg of chondroitin sulfate daily , both glucosamine and chondroitin sulfate , 200 mg of celecoxib daily , or placebo for 24 weeks . Up to 4000 mg of acetaminophen daily was allowed as rescue analgesia . Assignment was stratified according to the severity of knee pain ( mild [ N=1229 ] vs. moderate to severe [ N=354 ] ) . The primary outcome measure was a 20 percent decrease in knee pain from baseline to week 24 . RESULTS The mean age of the patients was 59 years , and 64 percent were women . Overall , glucosamine and chondroitin sulfate were not significantly better than placebo in reducing knee pain by 20 percent . As compared with the rate of response to placebo ( 60.1 percent ) , the rate of response to glucosamine was 3.9 percentage points higher ( P=0.30 ) , the rate of response to chondroitin sulfate was 5.3 percentage points higher ( P=0.17 ) , and the rate of response to combined treatment was 6.5 percentage points higher ( P=0.09 ) . The rate of response in the celecoxib control group was 10.0 percentage points higher than that in the placebo control group ( P=0.008 ) . For patients with moderate-to-severe pain at baseline , the rate of response was significantly higher with combined therapy than with placebo ( 79.2 percent vs. 54.3 percent , P=0.002 ) . Adverse events were mild , infrequent , and evenly distributed among the groups . CONCLUSIONS Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee . Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain . ( Clinical Trials.gov number , NCT00032890 . ) OBJECTIVES To investigate the effect of 12 weeks of strength training in combination with a nonsteroidal anti-inflammatory drug ( NSAID ) , glucosamine , or placebo on muscle cross-sectional area ( CSA ) , strength ( primary outcome parameters ) , and function , power , pain , and satellite cell number ( secondary outcome parameters ) in patients with knee osteoarthritis ( OA ) . DESIGN Double-blinded , r and omized controlled trial . SETTING Hospital . PARTICIPANTS Patients ( N=36 ; 20 women , 16 men ; age range , 50 - 70y ) with bilateral tibiofemoral knee OA . A total of 181 patients were approached , and 145 were excluded . INTERVENTIONS Patients were r and omly assigned to treatment with the NSAID ibuprofen ( n=12 ) , glucosamine ( n=12 ) , or placebo ( n=12 ) during 12 weeks of quadriceps muscle strength training . MAIN OUTCOME MEASURES Muscle CSA and strength . RESULTS No differences between groups were observed in gains in muscle CSA . Training combined with ibuprofen increased maximal isometric strength by an additional .22Nm/kg ( 95 % confidence interval [ CI ] , .01-.42 ; P=.04 ) , maximal eccentric muscle strength by .38Nm/kg ( 95 % CI , .05-.70 ; P=.02 ) , and eccentric muscle work by .27J/kg ( 95 % CI , .01-.53 ; P=.04 ) in comparison with placebo . Training combined with glucosamine increased maximal concentric muscle work by an additional .24J/kg versus placebo ( 95 % CI , .06-.42 ; P=.01 ) . CONCLUSIONS In patients with knee OA , NSAID or glucosamine administration during a 12-week strength-training program did not improve muscle mass gain , but improved maximal muscle strength gain in comparison with treatment with placebo . However , we do not find that the benefits are large enough to justify taking NSAIDs or glucosamine BACKGROUND Treatment of osteoarthritis is usually limited to short-term symptom control . We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms . METHODS We did a r and omised , double-blind placebo controlled trial , in which 212 patients with knee osteoarthritis were r and omly assigned 1500 mg sulphate oral glucosamine or placebo once daily for 3 years . Weightbearing , anteroposterior radiographs of each knee in full extension were taken at enrolment and after 1 and 3 years . Mean joint-space width of the medial compartment of the tibiofemoral joint was assessed by digital image analysis , whereas minimum joint-space width -- ie , at the narrowest point -- was measured by visual inspection with a magnifying lens . Symptoms were scored by the Western Ontario and McMaster Universities ( WOMAC ) osteoarthritis index . FINDINGS The 106 patients on placebo  had a progressive joint-space narrowing , with a mean joint-space loss after 3 years of -0.31 mm ( 95 % CI -0.48 to -0.13 ) . There was no significant joint-space loss in the 106 patients on glucosamine sulphate : -0.06 mm ( -0.22 to 0.09 ) . Similar results were reported with minimum joint-space narrowing . As assessed by WOMAC scores , symptoms worsened slightly in patients on placebo compared with the improvement observed after treatment with glucosamine sulphate . There were no differences in safety or reasons for early withdrawal between the treatment and placebo groups . INTERPRETATION The long-term combined structure-modifying and symptom-modifying effects of gluosamine sulphate suggest that it could be a disease modifying agent in osteoarthritis BACKGROUND Conventional symptomatic treatments for osteoarthritis do not favorably affect disease progression . The aim of this r and omized , placebo-controlled trial was to determine whether long-term ( 3-year ) treatment with glucosamine sulfate can modify the progression of joint structure and symptom changes in knee osteoarthritis , as previously suggested . METHODS Two hundred two patients with knee osteoarthritis ( using American College of Rheumatology criteria ) were r and omized to receive oral glucosamine sulfate , 1500 mg once a day , or placebo . Changes in radiographic minimum joint space width were measured in the medial compartment of the tibiofemoral joint , and symptoms were assessed using the algo-functional indexes of Lequesne and WOMAC ( Western Ontario and McMaster Universities ) . RESULTS  Osteoarthritis was of mild to moderate severity at enrollment , with average joint space widths of slightly less than 4 mm and a Lequesne index score of less than 9 points . Progressive joint space narrowing with placebo use was -0.19 mm ( 95 % confidence interval , -0.29 to -0.09 mm ) after 3 years . Conversely , there was no average change with glucosamine sulfate use ( 0.04 mm ; 95 % confidence interval , -0.06 to 0.14 mm ) , with a significant difference between groups ( P = .001 ) . Fewer patients treated with glucosamine sulfate experienced predefined severe narrowings ( > 0.5 mm ) : 5 % vs 14 % ( P = .05 ) . Symptoms improved modestly with placebo use but as much as 20 % to 25 % with glucosamine sulfate use , with significant final differences on the Lequesne index and the WOMAC total index and pain , function , and stiffness subscales . Safety was good and without differences between groups . CONCLUSION Long-term treatment with glucosamine sulfate retarded the progression of knee osteoarthritis , possibly determining disease modification Background Obesity is an important risk factor for knee osteoarthritis ( OA ) , Weight loss can reduce the symptoms of knee OA . No prospect i ve studies assessing the impact of weight loss on knee cartilage structure and composition have been performed . Objectives To assess the impact of weight loss on knee cartilage thickness and composition . Methods 111 obese adults were recruited from either laparoscopic adjustable gastric b and ing or exercise and diet weight loss programmes from two tertiary centres .  MRI was performed at baseline and 12-month follow-up to assess cartilage thickness . 78 eligible subjects also underwent delayed gadolinium-enhanced MRI of cartilage ( dGEMRIC ) , an estimate of proteoglycan content . The associations between cartilage outcomes ( cartilage thickness and dGEMRIC index ) and weight loss were adjusted for age , gender , body mass index ( BMI ) and presence of clinical knee OA . Results Mean age was 51.7±11.8 years and mean BMI was 36.6±5.8 kg/m2 ; 32 % had clinical knee OA . Mean weight loss was 9.3±11.9 % . Percentage weight loss was negatively associated with cartilage thickness loss in the medial femoral compartment in multiple regression analysis ( β=0.006 , r2=0.19 , p=0.029 ) . This association was not detected in the lateral compartment ( r2=0.12 , p=0.745 ) . Percentage weight loss was associated with an increase in medial dGEMRIC in multiple regression analysis ( β=3.9 , r2=0.26 ; p=0.008 ) but not the lateral compartment ( r2=0.14 , p=0.34 ) . For every 10 % weight loss there was a gain in the medial dGEMRIC index of 39 ms ( r2=0.28 ; p=0.014 ) . The lowest weight loss cut-off associated with reduced medial femoral cartilage thickness loss and improved medial dGEMRIC index was 7 % . Conclusions Weight loss is associated with improvements in the quality ( increased proteoglycan content ) and quantity ( reduced cartilage thickness losses ) of medial articular cartilage . This was not observed in the lateral compartment . This could ultimately lead to a reduced need for total joint replacements and is thus a finding with important public health implication OBJECTIVE To test the hypothesis that glucose intolerance does not occur when healthy adults consume normal , recommended dosages of glucosamine sulfate . METHODS Healthy adults ( N=19 ) ingested 1500 mg of glucosamine sulfate or placebo ( double blind ) each day for 12 weeks . Three-hour oral glucose tolerance tests ( OGTT ) were performed using 75 g of dextrose . These occurred before the start of supplementation , at 6 weeks , and at the completion of supplementation ( 12 weeks ) . RESULTS There were no significant differences between fasted levels of serum insulin or blood glucose .  Glucosamine sulfate supplementation did not alter serum insulin or plasma glucose during the OGTT . There were no significant differences within or between treatments , ages or gender . Glycated hemoglobin measurements at the three time points showed no significant change over time , within or between treatments , ages or gender . The lack of significant changes may have been due to large st and ard deviations in the data . CONCLUSION The data suggests that glucosamine supplementation , with normal recommended dosages , does not cause glucose intolerance in healthy adults . This can not be determined conclusively , however , until further studies are conducted using alternative types of testing Glucosamine is a popular nutritional supplement used to treat osteoarthrit 
    Output:
    
Based on a systematic review of the literature and the collection of recent data , the experts documented the effects of GlcN on cartilage ageing , metabolic/kinetic and maintenance of joint health as well as reduction of risk of OA development .