Patients diagnosed with OA by a physician were randomly assigned to one of two topical treatment groups in a double blind manner, receiving either (1) a cream consisting of a blend of CFA; or (2) a placebo cream.

The patients were tested on three occasions: at baseline, 30 minutes after initial treatment, and after 30-day treatment of cream application twice daily.

On each test occasion the selection of assessments and the sequence performed was (1) range of movement, (2) the timed up-and-go, (3) stair climbing test, (4) unilateral anterior reach, and (5) the medial step-down test.

40 patients completed the study (n = 20 per group; each matched group composed of 17 women and 3 men).

The topical cream used was a proprietary compound (Celadrin TM, Imagenetix, Inc., San Diego, CA, USA) that consisted of a blend of cetylated fatty acids (cetyl myristoleate, cetyl myristate, cetyl palmitoleate, cetyl laureate, catyl palitate, and cetyl oleate), PEG-100, state, benzyl alcohol, lecithin, carbomer, potassium hydroxide, tocopheryl acetate, and olive oil.

The placebo cream contained everything but the CFA base material. The topical cream was given to patients in coded tubes so neither the research team involved in the testing nor the patients knew which cream was administered.

Patients were instructed to apply a standardized amount of cream to both knees. Cream was applied to the anterior, posterior, and lateral aspects of both knees over a 10-12 cm area twice per day (at standardized morning and evening time points following a shower for 30 days).


The use of a CFA topical cream is an effective treatment for improving knee range of movement, ability to ascend/descend stairs, ability to rise from sitting, walk and sit down, and unilateral balance, strength, and endurance in patients with knee OA. A unique finding was the immediate effect of the treatment after the initial cream application.

The improvements with CFA were significantly greater than placebo, showing a beneficial effect of topical CFA application for improving timed up-and-go performance which suggests improvements in balance and strength (i.e. greater ability to eccentrically flex the support leg while maintaining body weight, stability and consequently extend the front leg a greater distance) possible resulting from chronic pain relief over the 30-day experimental period.

The results of this study provide support for the use of cetylated fatty acids as part of a pain relief treatment in patients with knee OA.

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