Joe A Shaw PA-C - 2/3/2008

Question
My husband suffered a fractured patella over 3months ago and is still in extreme pain with swelling.  He has had a wire and screws placed in his patella.  He takes 81 mg of aspirin and Plavix and was told by some pharmacists that he should take only glucosamine and not chondroitin or MSM for they should not be used with blood thinners.  Other pharmacists have said it is ok to take.  What is your opinion.  Should he take just glucosamine and how much?  Should he not take chondroitin and MSM?  Also, can he have an MRI of the knee with wires and screws?  His ortho doesn't seem concerned about his pain and swelling at all.  Thanks.

Answer
Laura,
Patellar fractures are very painful so maybe your ortho feels your husbands pain is "normal" so I'm sorry if he seems unconcerned. I typically don't prescribe or recommend that people take Gluc/chondrotin supplements...if they feel it helps and are going to take them I don't object (if that makes sense) In other words I don't endorse them because most studies have shown that they are really no more effective than Advil and they cost about $30-50/mo if taken as directed..and generic advil (Ibuprofen) is like $5. Of course antiinflammatories (NSAIDs) have concerns as well for some pts, as they too can increase risk of bleeding or ulcers, and recently effects on coronary heart disease. Celebrex seems to have less effects on platlets and a lower Ulcer risks. The other thing w any supplements is that they are regulated as FOOD so you never know what strength you are getting or how pure they are. Lastly there has been a suggestion that chondrotin has a relationship with causing prostate cancer, I will attach a link for you to read on that. The "official" stance of Glucosamine is that it does  or can put a pt at an increased risk of bleeding when combined with "blood thinners",,,How much risk I don't think anyone knows (some foods do the same thing as you probably know)
As you can see everything has a "risk/benefit" to it. If you are going to take these things I would definitely let your DR know.
NO they can't do an MRI of his knee.

http://prostateforum.com/info-chondroitin.htm