Chondroitin Sulfate in Osteoarthritis Treatment: A Twenty-Year Bibliometric Analysis and Comprehensive Review

Abstract

This study employs bibliometric methods to systematically analyze the research trajectory and frontier trends in the application of chondroitin sulfate (CS) for the treatment of osteoarthritis (OA) from 2005 to 2025. Through a visual analysis of 2,004 relevant articles from the Web of Science Core Collection, the field is revealed to have evolved through three distinct stages: from early pharmacological treatment and fundamental research, to the integration of tissue engineering and biomaterials, culminating in the current focus on intelligent therapeutic strategies centered on precision drug delivery systems. The findings indicate a global research landscape characterized by a "dual-core dominance of China and the United States." While China leads in publication output, its academic influence, as measured by citation metrics, lags behind that of European and American countries. Keyword analysis identifies "inflammation" and "drug delivery systems" as recent research hotspots, with targeted delivery systems based on biomaterials such as hydrogels and nanoparticles emerging as the technological frontier. The study also highlights persistent challenges in the clinical translation of CS, including issues related to delivery efficiency, material properties, largescale manufacturing, and interdisciplinary collaboration. Looking forward, by integrating smart responsive materials, multimodal synergistic therapies, and strengthening international cooperation, CS-based strategies hold promise for shifting the OA treatment paradigm from symptomatic relief to structural repair. This macro-level literature analysis provides datasupported insights to inform research planning, technological development, and translational pathways in the field.