Osteoarthritis is a chronic degenerative disease that develops slowly and progressively, and is the most common form of arthritis, characterized by wear and tear of the articular cartilage. Clinical treatment includes non-surgical and surgical treatment. The former is the mainstay. Drug therapy constitutes the main component of non-surgical treatment, including acetaminophen, non-steroidal anti-inflammatory analgesics, weak central analgesics, glucosamine, hyaluronic acid, hormones, etc. Among them, acetaminophen and non-steroidal anti-inflammatory analgesics are the most commonly used first-line drugs for osteoarthritis treatment because of their ability to relieve pain and control symptoms. Glucosamine, a naturally occurring amino monosaccharide derived from crabs and other shelled marine organisms, is an important structural component of glycosaminoglycans and hyaluronic acid, and thus serves as an alternative to endogenous articular cartilage nutrients. It can stimulate chondrocytes to produce proteoglycans with normal multimeric structure, improve the repair ability of chondrocytes, inhibit the release of hydrolytic enzymes such as lysosomal enzymes, collagenases and phospholipases, reduce the hydrolytic damage to the articular cartilage matrix, and prevent the production of superoxide radicals that damage cells and promote the repair and reconstruction of the cartilage matrix, thus delaying the pathological process of osteoarthritis and the disease process. Thus, as a nutritional supplement for articular cartilage I. What degree of osteoarthritis is glucosamine suitable for treatment A review of the available clinical studies on glucosamine in the treatment of osteoarthritis shows that almost all studies enrolled patients with mild to moderate joint pain, while the degree of wear of articular cartilage was not to the extent of major cartilage wear or even more severe. From the known effects of glucosamine on articular cartilage, it appears that glucosamine serves to repair and protect damaged articular cartilage and delay the course of osteoarthritis by regulating the metabolism of articular cartilage and replenishing the components needed to synthesize articular cartilage. This is the theoretical basis for the use of glucosamine as a potential drug to slow the progression of the disease. Therefore, most experts believe that the most suitable patients for clinical treatment of osteoarthritis with glucosamine should be patients with mild or moderate wear of articular cartilage, whose morphology and structure basically exist, rather than patients with extensive or even complete wear of articular cartilage, which belongs to the early osteoarthritis use drugs. Therefore, glucosamine can be used as a treatment option for early and mid-stage osteoarthritis, while it is not effective for patients with end-stage osteoarthritis with severe wear of articular cartilage. The efficacy and safety of glucosamine in the treatment of osteoarthritis A large number of clinical studies have shown that the safety of glucosamine in the treatment of osteoarthritis is very good, as reflected in the very few adverse events during the use of the drug, and the patient’s compliance with the drug is satisfactory. This is one of the reasons why the U.S. Food and Drug Administration has been able to classify these products as over-the-counter food supplements. III. Effective dose and duration of treatment of osteoarthritis with glucosamine The dose and duration of use of glucosamine has not been very standardized because it is applied as a food supplement in most countries. There are three main types of glucosamine: glucosamine sulfate, glucosamine hydrochloride and N-acetylglucosamine, and the first two varieties are currently predominant in the market. The majority of clinical studies that have yielded effective results with glucosamine for osteoarthritis have used glucosamine 1500 mg orally daily in 2 or 3 doses. The baseline pain relief rate at the time of enrollment in the clinical study was 60%, and 33% of patients had improved function. Fourth, the debate over the efficacy of hydrochloric acid versus glucosamine sulfate To date, most clinical studies have used glucosamine sulfate, and there is less evidence-based medical research on glucosamine hydrochloride for osteoarthritis, so there is controversy about whether glucosamine hydrochloride is effective in treating osteoarthritis. However, some clinical studies using glucosamine hydrochloride for the treatment of osteoarthritis have reached conclusions similar to those of glucosamine sulfate. Many manufacturers are also still producing large quantities of glucosamine hydrochloride for the prevention and treatment of osteoarthritis. This suggests that glucosamine hydrochloride is still viable for the treatment of osteoarthritis. In conclusion, glucosamine as a treatment option for osteoarthritis has been clinically effective in relieving the disease and alleviating symptoms, but it is appropriate to use it for early and preventive use in arthritis, and also for cartilage repair in patients with arthritis, and to continue to accumulate evidence-based medical evidence to further validate the safety and efficacy of glucosamine in the treatment of osteoarthritis.