Cheap and affordable substitutes for Alflutop: TOP 13 analogues

Prohibited during pregnancy

Prohibited during breastfeeding

Prohibited for children

Has restrictions for older people

Has limitations for liver problems

Has limitations for kidney problems

The lifestyle of a modern person is often associated with sedentary work and lack of physical activity, which, in turn, leads to the development of degenerative diseases of the osteoarticular system: arthrosis of various localizations, spondyloarthritis, rheumatic lesions. In such cases, drugs are prescribed that stimulate metabolism in joint tissues, as well as regulate the synthesis of collagen and other proteins necessary to ensure joint mobility.

Pharmacological effects of the drug

The group of chondroprotectors includes the drug Aflutop, which contains biologically active extracts of marine fish. They are rich in the following components that restore homeostasis in the osteoarticular system:

• chondroitin;
• amino acids;
• proteoglycans;
• phospholipids;
• minerals (calcium, magnesium, potassium, manganese, zinc, copper, iron).

Aflutop is available in transparent glass ampoules containing 1 ml of solution for intramuscular and intra-articular injections. There is no experience of use in pregnant women, lactating women and children under 16 years of age, and therefore it is worth refusing to prescribe the drug to the above categories of patients.

Aflutop has a large number of analogues with similar properties, but differing in price, release form and treatment regimen.

pharmachologic effect

Alflutop in ampoules is a chondroprotector and a remedy used for diseases of cartilage and articular apparatus. The product contains active concentrates obtained from sea fish. Alflutop is rich in chondroitin sulfate, amino acids and minerals, phospholipids. 1 ml of the drug contains 0.1 g of bioactive substance.

Natural components provide a quick and effective effect on cartilage tissue due to the following pharmacological effects:

• regulation of metabolism in cartilage;
• stimulation of collagen and hyaluronic acid synthesis;
• inhibition of the activity of enzymes that destroy cartilage structures, especially hyaluronidase;
• activation of restoration processes in cartilage;
• suppression of the production of inflammatory mediators, mainly cytokines;
• anti-inflammatory and analgesic effects;
• replacement of affected areas of cartilage, increasing their size, density and uniformity.

The effect of the drug is the result of the complex effect of its components on cartilage.

Tablet drugs

Chondroprotectors in the form of tablets have a cumulative effect. With long-term and regular use, they are able to restore the structure of bone and joint tissue and help eliminate the main signs of inflammation (pain, swelling, stiffness of movement). Alflutop has a sufficient number of analogues in tablets, which makes it possible to individually select treatment for each patient, depending on the intensity of the pathological lesion and financial capabilities.

Traumeel S

Refers to homeopathic preparations of plant and mineral origin, has many therapeutic effects:

• immunostimulating;
• restorative;
• anti-inflammatory;
• anesthetic;
• anti-exudative;
• reparative;
• chondroprotective.

Traumeel action

The main components of the tablets are calendula, arnica, belladonna, chamomile, echinacea, comfrey, St. John's wort, daisy. In orthopedics and traumatology, it is used to treat rheumatic and destructive diseases of the musculoskeletal system.

The most pronounced effect is observed when combining the tablet and external forms of the drug. Gel Traumeel S is used to treat arthritis of infectious, traumatic, rheumatic origin, to combat pain and swelling. The ointment has a pronounced effect in the treatment of bursitis, myositis, tendovaginitis, as well as skin diseases.

In advanced cases, Traumeel injections are prescribed. The dose of the drug depends on age and body weight. It is administered once every 7 days for 8-10 months. Most often used for intramuscular injections, however, to create maximum concentration in the pathological focus, intra- and periarticular injections are rational.

Teraflex

Belongs to a group of drugs that stimulate tissue repair. Restores the synthesis of interarticular fluid and increases its viscosity. Inhibits elastase and hyaluronidase, which leads to increased tissue elasticity. The following forms of the drug exist:

1. Theraflex capsules. The main components are glucosamine hydrosulfate (0.5 g) and chondroitin sulfate (0.4 g). Restores the fiber structure, provides mechanical protection, prevents the breakdown of hyaluronic acid and proteoglycans, and inhibits lipid peroxidation.

2. 
   Teraflex-Advance capsules. They combine mucopolysaccharides and the non-steroidal anti-inflammatory drug ibuprofen (100 mg). It has a pronounced chondroprotective and analgesic effect.

3. Teraflex-Chondrocream-Forte. Combined preparation for local use. Contains non-steroidal components - meloxicam and chondroitin. When applied to the affected area, it has a pronounced anti-edematous and analgesic effect, inhibits the destruction of elastic and cartilaginous fibers.

The duration of treatment is on average 2-3 months. Capsules are prescribed orally, 1 piece 3 times a day, regardless of the form of the drug.

Sustilak

The active ingredient is glycosamine hydrochloride (1.5 g), belongs to the group of stimulators of proteoglycan and collagen synthesis. Released in the form of modified-release tablets, which allows you to maintain optimal drug concentrations in the blood for 24 hours.

Sustilak is used for the treatment of arthrosis of various locations and for prophylactic purposes in women during menopause. When used in complex therapy, it allows you to reduce the dose of NSAIDs.

Kondronova

Refers to correctors of bone and cartilage tissue metabolism with pronounced reparative and anti-inflammatory properties. It consists of a combination of aminosaccharides, which are the structural basis of cartilage tissue - glucosamine and chondroitin sulfates. They provide firmness and elasticity to the joint surfaces and promote the production of a sufficient amount of synovial fluid.

When taking Cordronova, the breakdown of hyaluronic acid and proteoglycans is inhibited by inhibiting the activity of the enzymes hyaluronidase and elastase. When used in combination therapy, this medicine helps to significantly reduce the dose of anti-inflammatory drugs.

Main indications:

• osteochondrosis;
• arthritis of large joints;
• aseptic synovitis;
• spondylosis.

Take 1-2 capsules 3 times a day. Usually the duration of treatment is 2-2.5 months. To enhance the anti-inflammatory effect, it is rational to combine Cordronova lubricant for external use.

Structum

The drug is of animal origin and contains the glycosaminoglycan chondroitin, which is the basis of joint fluid and provides tissue protection from destruction. Helps normalize phosphorus-calcium metabolism and strengthens connective tissue structures. Inhibits the action of hyalorunidase, elastase, cathepsin and peptidase, thereby providing chemical protection to the articular surfaces.

Properties of Structum

The drug is prescribed as an adjuvant therapy in the treatment of gonarthrosis, coxarthrosis, and osteoporosis. You need to take 1 capsule 2-3 times a day for 6 months.

Artra

It is a stimulator of connective tissue restoration. The drug contains equal amounts of chondroitin and glucosamine (0.5 g each), as well as calcium phosphate. With long-term use of Artra, restoration of the structural components of the joint, an increase in the amount of synovial fluid is observed, and the strength and elasticity of connective tissue fibers increases.

The active components of the drug stimulate cellular metabolic processes, have moderate anti-inflammatory properties, and reduce the production of free radicals. A stable clinical effect is observed when taking 1-2 capsules 2 times a day for at least 6 months.

Arthrofon

Homeopathic remedy approved for use in children over 6 years of age. The active ingredient is a combination of purified antibodies to tumor necrosis factor. The drug improves microcirculation and inhibits the synthesis of inflammatory mediators. Used in the treatment of arthrosis and arthritis of various etiologies in combination with chondroprotectors, NSAIDs, and analgesics.

Arthrofon

The tablets are intended for sublingual administration. Take 2 tablets 4-5 times a day, after reducing the intensity of the pain syndrome - 1 tablet 3 times a day for 2-2.5 months.

Indications for use of Alflutop

Alflutop in injections according to the instructions for use is prescribed for the following degenerative and rheumatoid joint pathologies:

• osteoarthrosis: coxarthrosis, gonarthrosis, arthrosis of small joints;
• spondylosis;
• rehabilitation after injuries;
• recovery period after joint surgery.

For these diseases, complex therapy is more often used, which includes Alflutop and its analogues, as well as drugs from other pharmacological groups.

Alflutop - instructions for use

The drug is intended for use in adult patients.

Alflutop injections are administered intramuscularly at a dose of 1 ml per day. The duration of treatment is 20 days. It is possible to administer the drug intra-articularly according to the following regimen: 1–2 ml of the drug once every three days. The course of therapy is 5 injections into each joint. Repeat - after 3-6 months.

Alflutop is not prescribed for children, as well as for women during pregnancy and lactation. An allergy to the drug is also a contraindication to its use.

The drug is not mixed in the same syringe with other medications to avoid interaction reactions and complications for the patient.

Frequent side effects from using the product are burning and redness at the injection sites. Less often, pain increases with intra-articular injection, which is short-term. Allergic reactions are possible: rash, dermatitis, skin itching, anaphylactic shock.

In case of overdose, allergic manifestations are possible. Treatment of such complications is drug withdrawal according to the doctor's decision.

Alflutop is presented on the pharmaceutical market in gel form. Intended for local use at a dose prescribed by a doctor. Alflutop gel, as well as analogues in the form of ointments, are used both individually and in combination with parenteral forms to enhance their effectiveness

How to choose a similar drug?

Alflutop is being replaced by analogues due to its high cost. On average it is 1500-1800 rubles. However, there is a small group of patients who use another active ingredient due to an adverse reaction. For example, it could be an allergy. Then it is recommended not only to find an analogue, but also to select a different active component. Data on inexpensive substitutes are presented in the table.

Russian drugs are less expensive. Before purchasing a medicine, it is recommended to read the composition. There may be active substances to which the patient has an individual intolerance or an allergic reaction.

If a patient buys a medicine with a different active ingredient, it is better to consult with the attending physician and undergo laboratory tests.

Most medications come in the form of tablets or injections. The latter type is indicated for people who have an extensive inflammatory process that makes movement difficult and reduces the quality of life. Therefore, you need not only to select an analogue, but also to choose a dosage form.

How does Chondrolon help?

Chondrolone is a medicine based on chondroitin sulfate. Available in ampoules that are injected into the joint cavity. The pharmacological effect is formed due to proteoglycan (chondroitin sulfate):

• protection of the articular cavity and cartilage from damage;
• decrease in the activity of enzymes that cause deterioration in the renewal of the cellular composition of cartilage;
• stimulation of the production of additional chondroitin;

• increased metabolism;
• regeneration of the composition of bones and cartilage;
• anti-inflammatory effect;
• analgesic effect;
• stimulation of the production of synovial fluid, which softens the friction of bones and elements of the joint cavity;
• eliminating the risk of connective tissue collapse.

The drug is produced by the Russian company NPO Microgen JSC. It costs less than analogues, but has a high-quality effect. Indicated for use only for osteoarthritis of peripheral joints, as well as the spine. That is, its range of applications is smaller than that of Alflutop. Therefore, when choosing a remedy, it is recommended to review the clinical picture of the patient and accurately determine the diagnosis.

When to use Ambene Bio?

Ambene Bio is a Russian-made product based on a concentrated extract of small sea fish. Due to the active component, a chondroprotective effect is formed. Additionally, the following pharmacological effects are identified:

• saturation of the intra-articular cavity with minerals, amino acids, peptides;
• preventing tissue structure destruction;

• active healing, restoration of the joint cavity, which results in an analgesic effect;
• relieving inflammation, enhancing regeneration;
• active restoration of cartilage structure.

Like Alflutop, Ambene is used for osteoarthritis, osteochondrosis, and spondylosis. This is due to the fact that the active ingredients in them are identical. Therefore, the side effects and contraindications are fully consistent.

Interestingly, there have been no cases of drug overdose, but it is recommended to adhere to the dose prescribed by the doctor.

Since the composition contains components from various types of fish, the risk of an allergic reaction is increased. Among them, the development of local processes is possible, which are quickly eliminated when the drug is discontinued. Less commonly, anaphylaxis and Quincke's edema may occur. Therefore, when prescribing treatment, the doctor must collect an anamnesis, especially in the area of ​​immune response.

Chondroguard as an analogue

Chondroguard is a medicine produced in Russia by the company Pharmfirma Sotex. It is used in the form of a solution for intramuscular and intraarticular administration. The drug bypasses physiological barriers and directly enters the joint cavity. Therefore, the effectiveness is higher than tablets. The main active ingredient is chondroitin sulfate. It provides the following actions:

• stimulation of metabolic processes in hyaline cartilage;
• regeneration of damaged tissues, stimulation of synovial fluid synthesis;
• elimination of the inflammatory process with reduction of pain;
• increased range of motion in the affected joint cavities.

Even after discontinuation of the drug, its effectiveness remains for several months. The effect may last longer if the inflammatory process in the joints is small. The drug is indicated for use in degenerative-dystrophic diseases of the joints and spine. The drug quickly eliminates or suppresses the development of osteoarthritis and osteochondrosis, but its effectiveness is much greater if treatment is started in the early stages.

Unlike Alflutop, Chondroguard has many more contraindications for use. Among them are a tendency to bleeding, thrombophlebitis, active inflammatory and infectious processes in the joints, minor age, pregnancy, and lactation. Therefore, before prescribing the drug, it would be correct to undergo a coagulogram.

When to choose Artradol?

Artradol is a drug produced by Incampharm in Russia. This is a lyophilisate produced in ampoules. They contain sodium chondroitin sulfate. It provides the following effects on the body:

• slowing down the destruction and leaching of the mineral composition of bones;
• inhibition of cartilage tissue destruction;
• obstruction of connective tissue compression;
• lubrication of articular surfaces, preventing damage;
• slowing down dystrophy due to insufficient nutrition of the joint due to vascular pathologies;

• normalization of local metabolism in the articular cavity;
• renewal of the cellular composition of cartilage.

The drug is indicated for fractures, periodontopathy, osteoporosis, degenerative diseases of the joints and spine. It is indicated for a long course of use so that a high-quality effect occurs that does not disappear for a long time. The procedure is painful, so it is used with local anesthetics.

The only adverse reactions are allergies.

Since the composition contains natural ingredients, an allergic reaction often develops at the local level. This significantly distinguishes the drug from Alflutop, which can cause systemic pathologies in the form of anaphylactic shock. The product has a small number of contraindications. It is not recommended for use if you are prone to bleeding, thrombophlebitis, during pregnancy, or lactation.

Chondroxide ointment

Chondroxide is a drug in the form of a gel or ointment produced by Nizhpharm in Russia. Its cost is lower than that of other chondroprotectors, since it is used not in the form of tablets or injections, but locally. But the impact on the affected area will be significantly lower. Therefore, it is applied in cases where the lesion is small. The following indications for use are distinguished:

• osteoarthritis;

• osteochondrosis.

After application, the gel is quickly absorbed, spreading to the affected area. There is an effect on the cell membrane of cells. Therefore, the progression of osteoarthrosis and osteochondrosis is eliminated. An analgesic effect occurs. Inflammation, swelling, and stiffness of joints are eliminated. The cartilage begins to recover. Side effects occur much less frequently than with injection; only an allergic reaction is possible.

Contraindications include individual intolerance, as well as violation of the integrity of the skin. This is due to the fact that the patient risks introducing an infection inside and causing discomfort. Unlike other drugs for cartilage protection, chondroxide is approved during pregnancy and lactation. They can be used to treat children, but with caution.

Alflutop's analogs

Alflutop is an original drug that is produced by the Romanian pharmaceutical company Biotechnos in ampoules of 1 and 2 ml. A synonymous analogue with an identical composition is the drug Ambene Bio (Russia), which costs less and is produced in ampoules.

There are a number of effective substitutes for Alflutop, differing in composition, release forms, manufacturers, and cost. What these drugs have in common is a pharmacological effect on joints and cartilage, their restoration and improvement of metabolism. These analogues include the following drugs:

• products based on a complex of chondroitin and glucosamine - Teraflex, Protekon, Chondroitin complex, Artra, Artrafik pro, Chondronova, Chondroglyuksid;
• analogues containing glycosaminoglycans from cartilage extracts of young animals - Rumalon, Osteolon;
• expensive analogues based on Nusinersen, a new generation component - Spinraza;
• plant analogues - Piaskledin, Rumalaya, Doppelgerts Aktiv Revmagut, Osteoartisi, Revmagerb, Sustamar;
• analog drugs based on hyaluronic acid - Gialgan, Hialubrix, Fermatron plus;
• enzyme preparations that are active in joints and cartilage - Serrata, Movinase;
• analogues based on chondroitin - Injectran, Chondrolone, Artravir, Mucosat, Artrida, Movex, Chondrogard, Artogistan, Drastop, Artradol, Artrox, Structum, external preparations Chondroitin, Chondroflex, Hondra-sila;
• products that contain glucosamine - Sinarta, Artiflex, Glucosamine, Dona;
• drug based on nabumetone - Sinmeton;
• analogues that contain anti-inflammatory substances, especially NSAIDs - Movalis, Ambene Bio, Nimesil, Teraflex Advance, Melbek, Artroxan, Brexin, Xefocam, Chondroxide forte, Teraflex chondrocream.

List of Alflutop analogues with prices.

Alflutop or Rumalon - which is better and more effective for joint arthrosis

Manufacturer: Rompharm
Release form: ampoules

Active ingredient: glycosaminoglycans

Synonyms: Osteolon

Alflutop and Rumalon are included in the list of drugs with analogue effects. Differences in composition lead to differences in the indications for which these drugs are prescribed. Thus, Rumalon in injections is widely used for hernias, osteochondrosis, arthrosis of small joints, accompanied by severe inflammation. Both drugs contain substances of animal origin. Their effectiveness and safety have been proven by numerous studies. The anti-inflammatory activity of each drug is quite pronounced. Alflutop and Rumalon are often prescribed as part of complex therapy for joint pathologies in combination with anti-inflammatory drugs.

Rumalon is administered intramuscularly according to a scheme with increasing volume of the administered drug. Initial dose - 0.3 ml, then 0.5 ml and a maintenance dosage of 1 ml per day for 6 weeks. According to patient reviews, the drug is strong and effective.

Cheaper analogues of the drug in injections

Alflutop in ampoules, like most chondroprotectors, is an expensive drug. Since the treatment of bone and joint diseases requires long-term therapy, there is a need to select cheaper analogues of Aflutop in injections.

Mucosat

The drug is produced in Belarus pharma. According to the modern classification of drugs, Mucosat belongs to the group of non-steroidal antirheumatic drugs. The active effect of the drug is provided by sodium salts of chondroitin sulfate. They are proteoglycans and form the basis of cartilage tissue.

This drug has anti-inflammatory properties by blocking lipid peroxidation reactions and reducing the concentration of free radicals. Bone mineral density increases due to the normalization of calcium and phosphorus metabolism. The drug is available in the form of an injection solution. Typically used for intramuscular injections once a day, the average duration of treatment is one month.

Chondroflex

The main indication for the use of the drug Chondroflex is osteoporosis and osteochondrosis of the spine, since this medicine has pronounced regenerating, anti-inflammatory and mineralizing properties.

The components included in the composition (chondroitin, glucosamine) prevent the destruction of the cartilage membrane and improve the production of joint fluid. It also has a stimulating effect on the synthesis of proteoglycans and hyaluronic acid, which leads to a reduction in inflammation and pain.

Components of Chondroflex

This product is available in the form of an ointment for external use (30 g) and capsules for oral administration (100, 60 or 30 pieces per package). The injection form of the drug is currently not commercially available. To achieve the most pronounced therapeutic effect, complex therapy using various forms of medication is necessary. The minimum duration of treatment is 30-35 days.

Sinoart

Hyaluronic acid, which is part of the medication, is an essential component of synovial fluid, which ensures the elasticity of cartilage tissue. The drug has pronounced reparative and anti-inflammatory properties and helps to quickly relieve arthralgia. It is most often used for arthrosis of large joints (hip, knee, less often shoulder).

Osteoarthritis of the knee joint

The rapid clinical effect is due to the local action of this medicine - Sinoart is available in syringe tubes for intra-articular administration. A single dose of the drug is 2 ml (20 mg sodium hyaluronate). The therapeutic course consists of five injections, which are given once a week into the affected joint. Before the injection, it is important to remove exudate and excess interarticular fluid from the joint cavity.

The drug can be prescribed in complex treatment with other forms of chondroprotectors and anti-inflammatory drugs. Contraindicated in pregnant women and children under 18 years of age, as well as in the presence of hypersensitivity and severe liver failure.

Elbona

According to the modern pharmacological classification, Elbona belongs to the group of correctors of bone and joint tissue metabolism. Release form: ampoules for intramuscular administration. Each package contains a set of solvents (diethanolamine 2 ml) and 6 ampoules with the active ingredient (glucosamines).

Description of the drug

The drug has a pronounced anti-inflammatory, reparative, chondroprotective and analgesic effect. It is most often prescribed in complex therapy to improve joint mobility in patients with osteoarthritis and spondyloarthrosis. Combines well with non-steroidal anti-inflammatory drugs.

Approved for use in children over 12 years of age. The course of treatment consists of 10-12 intramuscular injections 3 times a week.

Considering the presence of lidocaine in the composition, use should be limited in persons with cardiac arrhythmias, cardiovascular insufficiency, and epilepsy.

Rumalon

According to the international anatomical and therapeutic classification, Rumalon belongs to the group of regenerants and reparants, correctors of mineral metabolism. The drug is of animal origin, made from cartilage and bone marrow tissue of cattle. Inhibits the processes of destruction of cartilage tissue, stimulates the production of joint fluid, hyaline and other mucopolysaccharides necessary to ensure the metabolism of cartilage.

Rumalon

Main indications for use:

• rheumatoid arthritis;
• arthrosis of the hip and knee joints;
• osteoporosis;
• chondromalacia patella.

The drug is intended for deep intramuscular administration and is available in ampoules of 1 and 2 ml of the finished solution. The treatment regimen consists of gradually increasing the dose. On the 1st day, 0.3 ml is administered, on the second - 0.5 ml, then you need to give an injection with 1 ml of Rumalon every other day for 2 months.

Don

It is classified as a chondroprotector and has reparative, anti-inflammatory and antioxidant properties. Differs in a variety of release forms:

• sachet with powder for preparing a drink;
• tablets for internal use;
• a set of ampoules with a solution for intramuscular administration and a solvent.

The active substance is glucosamine sulfate. The drug reduces inflammation in the joints, prevents the thinning of cartilage, and stimulates metabolic processes at the cellular level.

Action of Don components

It is most often prescribed for degenerative diseases of the spine, coxarthrosis, gonarthrosis, osteomalacia of the patella, and scapulohumeral periarthritis. To achieve maximum effect, it is recommended to combine the injection and oral forms of the drug. Long-term therapy is required, the minimum duration of treatment is 6-8 weeks.

Alflutop or Dona - which is better and more effective in injections

Manufacturer: Meda Pharma
Release form: ampoules, sachets, tablets

Active ingredient: Glucosamine

Synonyms: Sinarta, Artiflex, Glucosamine

Dona and Alflutop are drugs that are identical in their effects on joints and cartilage. The composition of the drugs is different, which explains the difference in their effectiveness and features of use.

The main indication for use of Dona is osteoarthritis with pain, accompanied by limited joint mobility. Alflutop has a wider range of applications. The method of administration for each drug is intramuscular.

Dona is also available in the form of tablets and powders for internal use. This allows the drug to be used in patients who cannot receive it parenterally, as well as as maintenance therapy.

Dosage of Dona in injections: 3-6 ml three times a week for 1-1.5 months. According to doctors, the effect of the drug may not appear immediately after administration; the effect is cumulative.

Dona or Alflutop - which is more effective?

Dona is available in three dosage forms: tablets, powders for preparing a drink and dilution for parenteral administration. Alflutop is presented in the pharmacy assortment only as an injection solution. Therefore, for a long-term course of treatment with Don, it is preferable - after 2-3 weeks of injections, you can proceed to taking tablets to consolidate the results obtained. But the therapeutic effectiveness of Don or Alflutop will be determined by studying the compositions of chondroprotectors:

• Don's active composition is represented by glucosamine sulfate, which inhibits enzymes that provoke premature destruction of the cartilage linings of the joints;
• The active ingredient of Alflutop is a deproteinized and delipidized substrate from fish of various families, which stimulates an increase in the production of hyaluronic acid and collagen.

Therefore, Alflutop quickly exhibits analgesic and anti-inflammatory effects. But they last as long as after parenteral administration of Dona. Alflutop is valued for its natural composition and narrow list of contraindications. Its advantages also include rarely occurring adverse reactions.

Alflutop or Chondroguard - which is better and more effective

Manufacturer: Sotex
Release form: ampoules

Active ingredient: Chondroitin sulfate

Synonyms: Injectran, Mucosat, Chondrolone, Drastop, Structum, Movex

Chondroguard is an analogue of Alflutop in injections in terms of pharmacological effects. The drugs differ in composition, manufacturers, and dosage regimens. Alflutop can be replaced with Chondroguard if the patient has dystrophic and degenerative disorders in the joints and vertebrae. The indications for Alflutop differ, so the possibility of replacing it with an analogue is determined only by a doctor.

Scheme for using Chondrogard: 100 mg of the drug intramuscularly with a possible increase in doses. The course of treatment is 30 injections.

Department of Traumatology and Orthopedics

article in PDF format

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V. B. TRETYAKOV

GBUZ SO "Samara City Hospital No. 7", Samara

Information about the author:

Vasily Borisovich Tretyakov – Samara City Hospital No. 7, Candidate of Medical Sciences, Head of the self-supporting department of traumatology and orthopedics, Russia, Samara, e-mail

For the period from 2012 to 2021. The department treated 186 patients with post-traumatic deforming osteoarthritis of the knee joint. The average age of the patients was 44 years (from 24 to 80 years). The patients underwent arthroscopic surgery on the knee joint: resection of the meniscus, removal of intra-articular bodies, arthrolysis and arthroplasty. In the postoperative period, comprehensive rehabilitation treatment was carried out: physiotherapeutic measures, exercise therapy, Alflutop injections, intra-articular injection of platelet-autologous plasma. Long-term treatment results were studied in 186 patients 12 months after completion of treatment. The result of the treatment was a decrease in pain, an improvement in the range of motion in the joint and its general functional state. Complex treatment of post-traumatic osteoarthritis of the knee joint made it possible to slow down the progression of the disease and improve the patient’s quality of life.

Key words: post-traumatic osteoarthritis, knee joint, arthroscopy, Alflutop, platelet-autologous plasma.

One of the most common and severe destructive-dystrophic lesions of the musculoskeletal system is osteoarthritis (OA). OA is characterized by a long and persistent course with a tendency to exacerbations and progression, damage to articular cartilage, other joint tissues and periarticular formations. The outcome of OA, as a rule, is a violation of the anatomy and function of the joint, a significant decrease in the quality of life and disability of the patient [4]. OA is the most common joint disease, affecting 11–13% of the world's population [1]. At the same time, diseases of the musculoskeletal system, where OA makes up a significant proportion, are the third most common cause of disability in the population of the Russian Federation, after cardiovascular diseases and oncological pathology [2]. The frequency of detected cases of knee OA (KS) is 13–29% of the total number of patients suffering from OA of large joints. There are primary and secondary forms of knee OA. The leading role in the development of secondary OA belongs to trauma (acute or microtrauma) of the joint. Injuries to the knee joint lead to the development of violations of the congruence of the articular surfaces and joint instability, which, as a rule, result in deforming osteoarthritis [3]. Therefore, the approach to the treatment of patients with knee OA should be complex and differentiated, and therapy should be long-term and systematic. The choice of treatment tactics should be based on the nature of the clinical picture of OA: joint pain, limitation of movements, crepitus, periodic effusion in the joint, inflammatory process without systemic manifestations. Strategic objectives in the treatment of knee OA: pain therapy, treatment of the disease, restoration of the patient’s motor activity, improving his quality of life. Complete and effective treatment of post-traumatic knee joint OA is possible only with early and accurate diagnosis of the nature of mechanical damage to intra-articular structures [6]. The nature of the pathology justifies the need for surgical intervention, arthroscopy, as the first stage of treatment. The goal of arthroscopic intervention is to accurately diagnose intra-articular pathology, since in its sensitivity, especially in the early stages of gonarthrosis, it is superior to modern non-invasive research methods such as magnetic resonance imaging and ultrasound. Simultaneous correction of existing mechanical damage to intra-articular tissues optimizes the conditions for regeneration processes in the area of ​​damaged cartilage [5]. An important role in the treatment of post-traumatic knee joint OA is played by medicinal and physiotherapeutic effects on the joint in the postoperative period. The main goals of therapy are: normalization of the condition of cartilage and synovial fluid, improvement of microcirculation in joint tissues, relief of pain and restoration of joint function. Regular physical activity and exercise occupy a significant place in the treatment of knee OA. The issues of organizing sanatorium-resort treatment of patients with post-traumatic OA of the knee have not lost their relevance [4].

The purpose of this study was to evaluate the results of using the drug Alflutop in the complex treatment of post-traumatic osteoarthritis of the knee joint using arthroscopic surgical techniques and intra-articular injection of platelet-autologous plasma.

Materials and methods

The results of treatment of 186 patients with post-traumatic OA of the joint, operated on using arthroscopic techniques in the self-supporting department of traumatology and orthopedics of the State Budgetary Healthcare Institution of the SGB No. 7 from 2012 to 2021 were studied. Men were 151 (81%), women – 35 (19%), average age patients were 44 years old. The main clinical symptoms of OA in patients in this group were: pain – 100%; periodic, emerging synovitis – 43%; limitation of movements – 26%; joint crepitus –16%. Patients underwent standard x-ray examination of the joint and MRI examination, 132 patients underwent ultrasound examination of the joint. At the preoperative stage, all patients were diagnosed with grade 1–2 OA. Surgical interventions were performed using spinal and general anesthesia. The progress and stages of the surgical procedure were recorded using video recording. KJ OA secondary to meniscus damage was diagnosed in 168 (90%) patients; in 12 (6%) cases, OA was combined with injuries to the anterior cruciate ligament, and in 6 (3%) – with traumatic cartilage defects. The following arthroscopic stages of OA were diagnosed: stage 1 – 43 (23%); stage 2 – 137 (74%); Stage 3 – 6 (3%). A discrepancy between the preoperative and arthroscopic diagnoses based on the assessment of the state of intra-articular cartilage was noted in 23 (27%) patients. Surgeries on the menisci (resection) were performed in 168 patients, reconstruction of the anterior cruciate ligament in 12 patients. 13 patients with traumatic cartilage defects underwent mosaic chondroplasty, 43 patients underwent tunnelization of bone tissue in the defect area. The average duration of inpatient treatment ranged from 2 to 4 days. Postoperative rehabilitation treatment was carried out individually, taking into account the volume of surgical treatment performed. According to indications, the limb was fixed and unloaded. Physiotherapeutic treatment and exercise therapy were carried out in full.

Drug chondroprotective therapy began in the early postoperative period after reactive changes in the joint had stopped. From 2 weeks after the operation, parenteral therapy with the drug Alflutop 1.0 No 20 was used intramuscularly for 1 course, with the course repeated after 3 - 6 months. Intra-articular injections of drugs of various groups play a role in the treatment of post-traumatic knee joint OA. In addition to intramuscular injections of Alflutop, we used intra-articular injection of platelet-derived autologous plasma (tAP). One of the generally accepted methods for obtaining tPA and its introduction into the knee joint was used. The drug was administered in a dose of 3 to 6 ml in the form of 5 single intra-articular injections with an interval of 7–10 days to 2 weeks.

results

Evaluation of the results of treatment in 86 patients was carried out on the basis of the patient’s subjective assessment of the level of pain and the functional state of the joint, as well as the use of objective assessment criteria. Questionnaires were filled out and clinical and instrumental examination of the joint was carried out. The complex treatment of knee OA allowed to improve the functional state of the damaged joint in 93% and slow down the progression of the disease in 90% of patients.

Conclusion

Many patients mistakenly believe that by performing arthroscopic surgery for post-traumatic knee joint OA, they will completely rid themselves of the disease and solve all the problems of their joint. But this is far from true - OA, as a disease, is irreversible and once it occurs, even with adequate treatment and prevention it continues to progress steadily. In the treatment of knee OA, it is important not only to eliminate intra-articular tissue damage that contributes to the development of the disease, relieve pain and restore joint function, but also to prevent further progression of degenerative changes in cartilage, bone and periarticular tissues. This opportunity is provided by an integrated approach to the treatment of post-traumatic OA of the joint: performing arthroscopic surgery, using the drug Alflutop, intra-articular injection of tPA, physiotherapy, and physical exercises. This allows not only to slow down the progression of degenerative changes in cartilage tissue, but also to restore the patient’s quality of life and avoid the development of early functional complications.

conclusions

1. Only conservative treatment of post-traumatic knee joint OA is unjustified, since this does not eliminate the immediate cause of its development (mechanical intra-articular damage), which ultimately leads to the progression of the development of the pathological process against the background of progressive destruction of the intra-articular elements of the joint.

2. Arthroscopy for post-traumatic knee joint OA is not only the most informative method for diagnosing and assessing the condition of intra-articular structures, but also the possibility of simultaneously performing a full-fledged surgical procedure. This makes arthroscopy a “no alternative” method for treating post-traumatic OA, especially in the early stages of its development.

3. The use of the drug Alflutop in the early stages of OA has a positive effect on the symptoms and course of the disease, improves the patient’s quality of life - these data confirm the symptom- and structural-modifying effects of Alflutop shown in randomized clinical trials. The drug has a favorable safety profile, is well tolerated by patients and can be used in the complex treatment of OA.

4. With the intra-articular administration of platelet-autologous plasma, not only the goal of stimulating regeneration is achieved, but also improving the sliding function of the joint, which makes this technique in combination with the parenteral use of the drug Alflutop optimal and safe.

5. An important component of the management of patients with knee OA, affecting symptoms, function and quality of life, is physical activity and exercise.

6. The proposed comprehensive approach to the treatment of post-traumatic knee joint OA allows to improve the condition of the damaged joint in 93%, and slow down the progression of the disease in 90% of patients.

Conflict of interest

Material prepared with the support of BIOTEHNOS

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THE USE OF THE DRUG ALFLUTOP IN THE TREATMENT OF POST-TRAUMATIC OSTEOARTHRITIS OF THE KNEE

Information about authors:

VB TRETYAKOV

GBUZ “Samara City Hospital No. 7", Samara

Tretyakov Vasiliy Borisovich – GBUZ “Samara City Hospital No. 7", Candidate of Medical Sciences, head of self-supporting department of traumatology and orthopedics, Russia, Samara.

Application of the drug Al utope in the complex treatment of posttraumatic osteoarthritis of the knee joint. For the period from 2012 to 2021 years, 186 patients with posttraumatic deforming osteoarthritis of the knee joint were treated in the department. e average age of the patients was 44 years (from 24 to 80 years). Patients underwent arthroscopic surgery on the knee joint: resection of the meniscus, removal of intraarticular bodies, arthrolysis and arthroplasty. In the postoperative period, complex restorative treatment was carried out: physiotherapeutic measures, exercise therapy, Al utop injection, intra-articular injection of platelet-autologous plasma. Long-term results of treatment were studied in 186 patients 12 months a er the end of the course of treatment. e result of the treatment was a reduction in the pain syndrome, an improvement in the volume of movements in the joint and its general functional state. Complex treatment of posttraumatic osteoarthritis of the knee joint allowed to slow the progression of the disease and improve the patient's quality of life.

Key words: posttraumatic osteoarthritis, knee joint, arthroscopy, Al utop, platelet-autologous plasma.

Alflutop or Mukosat - which is better and more effective?

Manufacturer: Diamed
Release form: ampoules

Active ingredient: Chondroitin sulfate

Synonyms: Chondrogard, Drastop, Artradol, Chondrolone

Alflutop and its analogue Mucosat in injections differ in composition, manufacturers, treatment regimens and cost. The doctor can replace the drugs if they are intolerable or if it is necessary to influence the cause of the disease with another active substance. Both drugs, according to doctors, are excellent means for the treatment of degenerative pathologies of joints, cartilage, and vertebrae.

Mucosat dosage regimen: 1 ml every other day with a possible increase in doses if the drug is well tolerated. The duration of therapy is 30 injections.

Alflutop and Artogistan - which is better

Manufacturer: Grotex
Release form: ampoules

Active ingredient: Chondroitin sulfate

Synonyms: Chondroguard, Drastop, Artradol, Chondrolone, Mucosat

Only a doctor can choose the best option for treating patients with Alflutop or Artogistan, taking into account the characteristics of the course of the disease and its causes. Both products have identical effects and the same methods of administration. Artogistan is a high-quality analogue of Alflutop in injections made in Russia, which can be purchased in most pharmacies with a doctor’s prescription.

Dosage of Artogistan: 100 mg of the drug every other day intramuscularly. It is possible to increase the dose. The duration of therapy is 30–35 injections.

How effective are Russian drugs?

Many people try to treat joint pathologies with medications produced by foreign pharmacological companies. In fact, there are many Russian-made products that are not inferior to them in efficiency. They consist of identical active components and therefore lead to the same pharmacological actions. But the price of Russian drugs is much lower.

The average cost of the Russian analogue of chondroprotector is 600-1100 rubles. If you use ointment, the price will be even lower. But when choosing a product, it is not recommended to replace it yourself, especially if it contains another active component.

Based on the example of tests, it was confirmed that Russian drugs from the group of chondroprotectors have identical activity to foreign drugs. They contain the same active ingredients. But the price of foreign competitors is higher, since more money is spent on the production of the product and transportation to another country is required.

Alflutop or Ambene Bio - which is better?

Manufacturer: NC Pharmaceuticals
Release form: ampoules

Active ingredient: bioactive extract from small sea fish

Synonyms: Alflutop

Ambene Bio is an analogue of Alflutop in injections, the price of which is lower. The composition of the products is identical, the differences are in the manufacturers. Alflutop is a drug for which all the necessary studies on bioavailability, effectiveness and safety have been carried out. The choice of an analogue drug is best left to the doctor, who will assess the patient’s condition and select the correct treatment regimen.

The dosage of Ambene Bio is no different from Alflutop: 1 ml per day for 20 days in a row intramuscularly. If necessary, intra-articular administration of the drug is possible.

Alflutop and Drastop injections - which is better

Manufacturer: Word Medicine, UK
Release form: ampoules

Active ingredient: Chondroitin sulfate

Synonyms: Chondroguard, Artradol, Chondrolone, Mucosat

Drastop is a substitute for Alflutop in ampoules due to its effects on the condition of cartilage and joint tissue. Differences in the composition and manufacturers, as well as dosage regimens of drugs. The general effect on the condition of cartilage and joints allows the doctor to make a replacement in case of intolerance to Alflutop or for other reasons. This is also a good analogue if the patient is looking for a cheaper alternative to Alflutop injections.

Dosing of Drastop: administer 1 ml intramuscularly every other day. If necessary, the dose may be increased. The average duration of therapy is 30 injections.

Alflutop or Injectran - which is better and more effective

Manufacturer: Ellara
Release form: ampoules

Active ingredient: Chondroitin sulfate

Synonyms: Chondroguard, Artradol, Chondrolone, Mucosat

The product based on chondroitin sulfate Injectran is an analogue of Alflutop. The effects of the drugs are identical, so such drugs can be interchangeable. In childhood, medications are not prescribed. The doctor selects doses and schedules of drug administration; a combination of analogues is possible, depending on the severity of the patient’s condition.

Injectran dosage regimen: 1 ml every other day, 30 injections in total.

What kind of drug is this?

Alflutop is a medicine based on fish extracts. Due to the concentration of these substances, a chondroprotective effect is formed. The drug is characterized by the following pharmacodynamics:

• preventing the destruction of cartilage tissue and other joint structures;
• stimulation of renewal of the cellular composition of tissues, including articular cartilage;
• slight analgesic effect;
• elimination of the inflammatory process;
• stimulation of the synthesis of hyaluronic acid, hyaluronidase.

Indications for use include osteoarthritis, spondylosis, and osteochondrosis. These are pathologies in which an inflammatory process of the articular cavity occurs, associated with the destruction of cartilage tissue. The product has a beneficial effect on the body, only in rare cases causing side effects:

• rarely allergic reactions occur in the form of skin redness, itching, burning, peeling;
• anaphylactic reactions;
• short-term muscle inflammation;
• strengthening of the inflammatory process.

Most of the negative effects occur if the drug is administered by injection into the intra-articular cavity. The drug is contraindicated in case of individual intolerance, pregnancy and lactation, and minors. The medicine has not undergone sufficient clinical trials, so it cannot be recommended for all groups of patients.

Why are injections used?

Many patients do not understand why chondroprotectors need to be injected. For example, Alflutop. This is due to the following factors:

• complete penetration of the active component of the drug into the affected area, which increases its effect;
• rapid anti-inflammatory and analgesic effect;
• active renewal of cartilage tissue cells and synovial fluid.

If you choose a drug that is used in the form of tablets or ointments, the effect will be 2-3 times lower than from injections. When taken orally, the drug passes through the gastrointestinal tract, so part of it is eliminated. Only a small fraction of the active component of creams and gels penetrates deep into the tissues. This reduces the pharmacological effect.

If your doctor recommends injections, they can be used in several forms. Intramuscular administration is indicated for patients who develop severe joint pain, when it is impossible to inject directly into the cavity. However, the greatest effect is achieved with intra-articular injections. Therefore, for osteoarthritis, osteochondrosis, and other cartilage pathologies, this particular form of administration is prescribed.

Alflutop or Chondrolon - which is more effective?

Manufacturer: Microgen
Release form: ampoules

Active ingredient: Chondroitin sulfate

Synonyms: Chondroguard, Artradol, Mucosat

Chondrolone is an analogue of Alflutop in ampoules, which is cheaper. The drug is characterized by a similar effect on the condition of cartilage and joint tissues. According to the indications and recommendations of the doctor, the analogues are interchangeable. They differ in composition and dosage regimens, so the course of treatment with such analogues will be different. A cheap substitute for Alflutop shows a good effect when used correctly and in compliance with dosages.

Dosing of Chondrolone: ​​1 ml every other day intramuscularly. Depending on the severity of the disease, the dose of the drug can be increased. The duration of therapy is at least 25 injections.

Rumalon or Alflutop - which is better?

Rumalon and Alflutop are first-generation chondroprotectors, characterized by a wide spectrum of action and high efficiency. This led to their wide popularity despite the existence of more modern second and third generation chondroprotectors.

Rumalon or Alflutop - which is better, what are the features and differences of the drugs:

1. Rumalon and Alflutop are glucosamine preparations with a wide spectrum of action.
2. Both drugs are available in the form of an injection solution - but Rumalon is administered only intramuscularly, while Alflutop is administered both intramuscularly and intraarticularly.
3. Due to the method of administration, Rumalon has a narrower list of indications for use.
4. Alflutop provides a rapid therapeutic effect, so the course of treatment with this drug is much shorter than its analogue.
5. Rumalon should not be used for rheumatoid arthritis; Alflutop is not used for seafood allergies, since it contains an extract from sea fish.

When choosing between Alflutop and Rumalon, you need to take into account that the first drug is considered more effective, but it causes side effects much more often than its analogue.

Teraflex

Manufacturer: Health Life, UK
Release form: capsules

Active ingredient: chondroitin, glucosamine

Synonyms: Protekon, Chondroitin complex, Artra

Teraflex is an analogue of Alflutop in capsules and tablets with a combined composition, which is used for pathologies of cartilage and joints. They also produce Teraflex Advance, which additionally contains the anti-inflammatory component ibuprofen. It is prescribed for more severe pain and inflammatory syndromes. The analogue is intended for oral administration, which slightly reduces its bioavailability and the rate of onset of effects compared to Alflutop.

Teraflex dosage: 1 capsule three times a day. According to the doctor's instructions, the dose of the drug can be reduced. The duration of treatment is determined by the doctor.

Answers on questions

Is Alflutop a painful injection or not?

When Alflutop is administered, especially intra-articularly, pain, redness and burning may occur. Such effects are temporary and are not complications of therapy with the drug and its analogues.

When is it better to inject Alflutop - in the morning or in the evening?

The drug, like its analogues, is administered at any suitable time of the day. It is recommended to maintain a time interval between administrations of different medications in the case of complex therapy of diseases.