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Joint-Arthritis, With Enzimic Treatment

*Dr.Chakravarty Adusumalli  M.D

*Consultant Orthopaedic Surgeon, Specialist  for Arthrosis,
  Kachletstrasse 50, 94034 PASSAU, Germany

Address for Correspondence:
Dr.Chakravarty Adusumalli  M.D
*Consultant Orthopaedic Surgeon, Specialist  for Arthrosis,
  Kachletstrasse 50, 94034 PASSAU, Germany.
Tel/F +49 851 72521
E mail

Key Words: Enzimic-German research product


Between 1987 and 2000, 1019 patients with painful arthritic hips, knees, shoulders, elbows, and ankles were treated with enzimic solutions. The mean period of fallow-up was 48 months.

Nearly 80% had good and fair results; 20% had poor relief from pain by the objective criteria of the Markandeya’s performance score. 205 have required arthroplasty at a mean of  12 months  with good and satisfactory results.

The rate of success when the procedure was performed for inflammatory arthritis, post-traumatic arthritis and arthrosis. It is rarely indicated in the presence of generalized inflammatory arthritis, but may be value  in those patients in whom the disease is limited primarily knees, shoulders, and hips.

The strategy to restore the joint has revolved a basic formula and the aim is to describe the broad principle of the conservation of the joint with the non-surgical treatment for the relief of pain and prolongation of the joint-life. Average estimated cost of the procedure is around  € 225 and may vary from country to country about 10%. In a country like India it will be around Rs.5,000 to 10,000.

J.Orthopaedics 2005;2(6)e2

Patients and Methods

Between 1987 and 1999, we treated 1019 patients joint-pain which is the main cause for human misery, and time lost from work in terms of sick leave. Though various surgical treatment methods are developed in the past decades, still, none of them is very successful in all aspects. An alternative treatment is to inject enzyme-solutions directly in the joint-cavity which dissolve damaged cartilage and improve lubrication between the joint-surface, and to regenerate the cartilage. It is known as a fact, that the capacity to repair joint-cartilage is limited. It is presumed ulcerated cartilage is a troublesome thing, and when degenerated it cannot be recovered. There has been acceptance of the common and random degeneration of the joints with aging. Belief that degeneration may be arrested, repaired, and reversed have often been disregarded or viewed with cynicism. After all , if it gets bad enough, it can be replaced with a prosthetic   , is the attitude of many surgeons.

Cartilage defects on the articular-surface do not heal spontaneous and generally progress to more widespread degeneration. With time, although fibro-cartilage fills and covers the surface defects, with temporary relief of pain, unlike hyaline cartilage, it will resist pressure but not compression which is needed to withstand longterm loading and shearing force and allow smooth articulation. This is also helped by the low coefficient of friction of hyaline cartilage.

To select a treatment , is to remove degenerated articular-cartilage from the articular surface and induce cartilage cell proliferation. Regeneration of the cartilage described here with the formation of an entirely new joint-surface, to duplicate the original articular-surface. This has proved to some as possible, with variable results and good prognosis.

The treatment of arthrosis and arthritis by means of medical plants, as described in the article by Th.Weilmayer, that was published in the periodical “Fortschritte der. Medizin".4, discloses a number of therapeutic  approaches such as physiotherapy through the aid of low temperatures, by means of a diet of raw vegetables, an exclusive diet of juices or even through biological product therapy  by means of extracts from arnica, hot pepper, camphor with essential oils and a number of biological-pharmaceuticals  such as the use of vegetable solutions.

Enzymic solutions  were introduced 1 for the treatment of joints. It is a solution purified from the herbs and fruits. The initial report demonstrated with video-prints in 1992 and 1997. Apart from the unusual appearance of the joint-space widening, the joint-pain was disappeared and, the stiffness in the joint had decreased within four weeks.

Table 1 : Hip joint comparative study

          Comparative study after 10 injections A + B solutions  and the drug Xylocoin 1% (Blind controlled, study)

No. Of    persons treated in 1994

A + B drug 5ml

Xylocoin 1% 5mlml

6 patients

6 patients

10 injections twice a week

10 injections twice a week

Duration of  period after the last injection


               6  weeks


6 weeks




4 ( 66. 6%)

1 (16,6%)

1 (16,6%)



6 (100%)








The effect of Xylocoin is restricted to, only a few hours of pain relief. After 10  moreinjections  the patient showed no signs of pain relief or improvement.

The pain relief after the first injection with the combination of drug A+B lasted for four    days. After 10 following injections the patients were relieved of pain and the movements in the hip-joint improved. In 1999 two patients turned up to show their hip-joints. The clinical results were excellent.

Table 2: Knee-joint comparative study

Comparative study after 10 injections, solution (Enzimic)

 5 ml Enzimic 10 patients

Xylocoin  1% 5 ml

10 patients

Twice a week for 5 weeks

Left knee 5,   right knee 5

Left knee 5,   right knee 5

Control study after 12 weeks

Good 7     70%

Fair    1     10%

Poor   2     20%




Control study after  24 weeks

Good  6   60%

Fair     3   30%

Poor   1    10%



Poor     10 (100%)

Good-normal activity, joint free from pain for 24  months.
Fair-normal activity, fre
e from pain but night discomfort. Not bad enough to open surgery. Poor-severe pain, no improvement, later open-surgery.

Number of patients treated 1019.

Table 3: Comparison and distribution, in different age groups, and different joints.

Age group






















































Joints treated from 1987 till 1997

Hip-joints                     717                                                      70.3%
Knee-joints                  132                                                      12.9%
Shoulder-joints             107                                                      10.5%
Elbow joints                 29                                                        2.8%
Ankle-joints                  34                                                        3.3%

The amount of Enzimic solution needed for one joint: In small joints the amount can be reduced accordingly. When less-amount was used, the rest can be applied for some other patient. Quantity used for each joint at a time. Equal amount of A and B enzimic mixed before injecting. Ten injections are needed for one joint.

Enzimic A solution: Fruct. Symphoricapi, Herb. Euphorbiae,Gold tetrachlorric.
Enzimic B s
olution: Arnica D2, calendula, chamomilla, symphytum, millefolium, belladonna, aconitum, bellis perennis, hypericum, echinacea, herpar sulfuris.

Table 4

From 1987 to 1999.

Hip joints   4- 5 ml

Knee joints

3-4 ml

Shoulder joints 3 ml

Elbow joints 2 ml

Ankle joints 2 ml


Total number of patients  1019

Mean values, for function, without pain, and range of movement for each group at each fallow-up intervals according  Adusumalli

Table- 5: ( Hip-Knee- shoulder- and other joints  )

Results after                   12 months       24 months        36 months        48 months

Hip joints treatment

Good .                                     555                                          466                     65
Fair .                                        83                                            10                       4
Poor .                                       79                                            84                        34
Control number                      (717)                           (560)                   (104)

Knee joints

Good                                       112                                          31                      38
Fair                                          18                                            11                       8
Poor                                         2                                              33                      16
Control number                  (132)                                              (75)                   (66)

Shoulder joint

Good                                       87                    63                    64
Fair                                          15                    13                    12
Poor                                         5                      13                       6
Control number                        (107)                (89)                  (82)

 Results     -                               12 months.                                          48 months

Good                                       56.3%  ----20.8%                                41.7%---33.3%
Fair                                          12.5% -----37.7%                               16.6% ---22.2%
Poor                                         37.2%  ----41.7%                                41.7% ---44.5%
Control number                        29             34                                       13          16

Controlled study of Enzimic solution in four different ways (Stability study)

Stability of the drug after mixing A+B solution and kept at room-temperature 20o C for 12 months and 36 months.(after mixing) the solution, is named Enzimic).

Table 6

Time period 1996-97

A+B sol.




Solution used

A+B separately injected

A+B injected after mixing

A+B mixed,stored 12 months


A+B mixed,stored 36 months


No:persons  treated









 after six weeks





         5 (83.3%

        1 (16.6%



         6 (100%)




          6 (100%)




         6 (100%)



after six months





           5 (83.3%)

           1 (16.6%)


        6 (100%)



        6 (100%)



         6 (100%)


Comments : 

Not much difference was observed between the three combinations, except injecting one after another.

The treatment can be carried out with one injection, instead of mixing before injecting. It saves time, and reduces the production cost.

Three individual orthopedic surgeons have carried-out, the above treatment independently for the stability and effectiveness of the solution.








  Figure : 1                          Fig 1 a                                Fig 1 b

67 year old women  with osteoarthritis of the right hip-joint. a)Before treatment a dye was injected to show the degenerated cartilage. b) after 10 injections the joint was cleaned, after 24 months. The patient is free from pain and free movements in the joint.









 Figure:2                   fig 2 a                                            Fig 2 b

 69 year old woman osteoarthritis of the left knee a) Before the treatment- an anteroposterior plain vidio showing extensive loss of cartilage tissue  b) after 36 months. The patient was free from pain and able to do her house work. Cartilage tissue regenerated.

Cost of the drug ,when manufactured in that country 2004 for the treatment of  one joint ( Hip or Knee)

Table 7: Cost of the drug to treat one joint 10 injections. 2003

East Europian








€  110.   


 $ 365.00



  € 140.


   € 250.


€ 250.


Rs 5,000



According to WHO ( 2003) nearly  5 to 10% of the population need joint-treatment. In India over 50 million people. The cost of  endoprosthetic replacement in India is around Rs.150,000, where as enzimic treatment Rs. 10,000 for one patient.

There is still uncertainty as to choose initial–arthroplasty  or to try non-surgical treatment. At present, there is little to chose between the two. In our series the rate of success of 80 to 82% even after 4 years.(Table 5) The aforementioned treatment has one common denominator, for the joints. The aim is to decrease the joint pressure sufficiently by removing the damaged, degenerated tissues and widening the joint space. With that, the joint-cartilage may regenerate to some extent and pain disappears.( Fig. 1,Fig 2 )

It is important to stress that not all the commercially available joint-replacement will satisfy all the patients with the joint-pain. Enzimic inter-articular treatment was found to be very effective alternative means of providing relief of pain due to joint diseases, like osteoarthritis, rheumatoid-arthritis, and arthroses. The success of Enzimic therapy  is in achieving prolonged pain-free joint for the patient, more than 4 years in average after the initial course, and the patients showed 80 to 82% (Table 5 )free from pain in hip-, knee-, and shoulder-joints. Of these patients changes the pattern of work in an Orthopedic and surgical units considerably, while patients admitted in joint-replacement operation might otherwise have occupied a bed for average 3-4 weeks, now they occupy no bed, the workload and economic aspects enormously decrease.

Demands on the physio-therapy are also changed with decrease in the need for inpatient physiotherapy and a corresponding drop in out-patient requirements.

My series had encompassed the most difficult patients; the active, elderly and young. Perhaps the most far-reaching effect of Enzimic treatment on the general practice, is the pattern of referable. It appears from clinical evidence that it may be safely injected in the joint. It is unquestionable benefit when used for joint-disease. There is enough satisfactory evidence from this intra-articular treatment, which can reduce the cost of joint replacement as an economical aspect, and at the same time improves the condition of the joint to the patient’s satisfaction. The risk of loosening or infection does not exist. We have demonstrated that Enzimic inter-articular treatment can achieve results comparable to those of conventional joint-replacement in terms of pain relief, walking, function, and range of motion. Further, their own stability and practically no risk of sepsis.

It was noteworthy that the improvement in the joint was mostly due to cartilage regeneration in the joint ( Fig 1,and Fig 3). It is important in terms of function without pain. In terms of radiological analysis there appears to be enlarged joint-cavity with considerable improvement in the joint and stability.

The future role of non-surgical treatment is a subject of debate and contravention. The present indication, instead total joint replacement to restore the joint as far as possible, a life saving of the joint. In time, it is to be hoped that many doctors with an interest of joint restoration will adopt the use of an Enzimic treatment. It may well be that the non-surgical treatment will prove to have the same effect on surgery. There is no doubt that the intra-articular treatment of joints with enzimie will bring a change in the position of joint surgery, only time will confirm what that change will be.

The author wishes to thank WHO,at Geneva for their help with the statistical data regarding health around the world.

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.


1.Adusumalli C.,Hip joint restoration (Non surgical treatment of joint).I Journal of        Orthopaedics 2002,36-4, 274-5
. Akamatsu Y, Koshipo T, Saito T, Wada J. Changes in osteosclerosis of osteoarthritic knee after high tibial osteotomy. Clin Orthop  1997; 334:207-14
. Buckwalter JA, Mankin HJ. Articular cartilage:part 1. Tissue design and chondrocytematrix interactions. Part 11. Degeneration and osteoarthrosis repair and regeneration and transplantation J Bone Joint Surg(Am) 1997; 79-A:600-32
. Briggs AH,etc.Pulling cost-effectiveness analysis up by its bootstraps:a non parametric approach to confidence interval estimation. Health Econ 1997;6:327-40
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 This is a peer reviewed paper 

Please cite as : Chakravarty Adusumalli: Joint-Arthritis, With Enzimic Treatment

J.Orthopaedics 2005;2(6)e2





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