Change in knee osteoarthritis cartilage detected by delayed gadolinium enhanced magnetic resonance imaging following treatment with collagen hydrolysate: a pilot randomized controlled trial

McAlindon TE, Nuite M, Krishnan N, Ruthazer R, Price LL, Burstein D, Griffith J, Flechsenhar K · Osteoarthritis and Cartilage

The only trial that has ever imaged cartilage during collagen supplementation. dGEMRIC score — a validated proxy for cartilage proteoglycan content — rose in the medial and lateral TIBIAL regions on collagen (median +29 and +41 ms) while falling on placebo, reaching significance at 24 weeks. Everything else was null: no significant change in the other four regions of interest, none in any T2 value, and none in any clinical outcome.

Population

Adults with mild knee osteoarthritis, single centre

Intervention

A formulation of collagen hydrolysate, 24 weeks primary and 48 weeks secondary

Comparator

Placebo

Limitations

Described by its own authors as a pilot, n=30, single centre, with hedged wording ('may be able to detect change'). Significant in 2 of 6 regions of interest, with all T2 measures and ALL clinical outcomes null — so no participant felt better. Registered as NCT00536302 with GELITA as lead sponsor (industry class, internal ID 'Gelita TM 1'); co-author Flechsenhar is at Gelita Health. Never replicated in the 15 years since, despite a large commercial incentive to do so.