Osteoarthritis management through medical reversal: Glucosamine, Alzheimer's disease risk, and long-term outcomes after arthroscopic partial meniscectomy

Abstract

The adoption of interventions in osteoarthritis and musculoskeletal care frequently precedes the availability of robust long-term evidence, creating the conditions for subsequent medical reversal. Recent findings raising concern about possible adverse neurocognitive associations with glucosamine use challenge the assumption that widely used supplements are necessarily biologically inert, although their causal significance and direct relevance to routine osteoarthritis management remain uncertain. In contrast, 10-year follow-up evidence after arthroscopic partial meniscectomy for degenerative meniscal tears provides a more established example of medical reversal, demonstrating no sustained clinical benefit over sham surgery and raising concern regarding structural harm. Evidence concerning repeated intra-articular corticosteroid injections similarly illustrates the limitations of relying on biological plausibility or short-term symptomatic outcomes. These examples, while differing in evidentiary maturity, support a common principle: orthopaedic interventions should be evaluated according to rigorous comparative evidence and durable patient-centred outcomes. Clinicians should communicate uncertainty, avoid treating structural abnormalities or mechanistic rationale as sufficient indications for intervention, and remain willing to revise established practices when stronger evidence emerges.