{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T10:05:10Z","timestamp":1781085910677,"version":"3.54.1"},"reference-count":72,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Knee osteoarthritis (KOA) is increasingly recognized as a function-limiting condition in which pain, neuromuscular impairment, and reduced physical activity interact with sarcopenic vulnerability to accelerate functional decline. This review reappraises commonly used oral nutraceuticals through a muscle\u2013joint framework and examines whether they can be conservatively positioned as adjuncts that reduce symptom-related barriers to exercise-based care rather than as disease-modifying therapies. Methods: This review was conducted as a structured narrative synthesis informed by SANRA principles, using a structured and transparent search process and dual-independent study selection, without quantitative meta-analysis or formal certainty-of-evidence grading. PubMed\/MEDLINE, Embase, and the Cochrane Library were searched for English-language studies published from January 2000 to March 2026, supplemented by reference screening of key reviews and international guidelines. Results: Mechanistic and clinical evidence supports a plausible pathway linking KOA pain, arthrogenic muscle inhibition, reduced loading, physical inactivity, and sarcopenic vulnerability. Across glucosamine\/chondroitin, collagen peptides, omega-3 fatty acids, curcumin, and Boswellia, symptomatic benefits were modest, heterogeneous, and formulation-dependent, with no consistent evidence of structural disease modification. Direct evidence that nutraceuticals improve exercise adherence or long-term physical activity remains limited; however, selected exercise-integrated or function-oriented studies show participation-relevant signals in gait speed, activity volume, and performance-based outcomes. Conclusions: Nutraceuticals should be interpreted as optional, time-limited adjuncts within exercise-centered KOA management. Their potential value lies in modest symptom support that may facilitate rehabilitation participation in selected patients, not in stand-alone treatment of KOA or sarcopenia.<\/jats:p>","DOI":"10.3390\/nu18121871","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:25:17Z","timestamp":1781083517000},"page":"1871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reframing Nutraceuticals in Knee Osteoarthritis with Sarcopenia: A Muscle\u2013Joint-Centered Narrative Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4518-7847","authenticated-orcid":false,"given":"Dojoon","family":"Park","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae-Seok","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2538-4579","authenticated-orcid":false,"given":"Youn-Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Wook","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilkyu","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Bucheon 14647, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1056\/NEJMcp1903768","article-title":"Osteoarthritis of the Knee","volume":"384","author":"Sharma","year":"2021","journal-title":"N. 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