Hyaluronic Acid in the Treatment of Pain Due to Knee Joint Immobilisation

Marco, Carmelo Di; Letizia, G

doi:10.2165/00044011-199510040-00001

Cited by 9 publications

(6 citation statements)

References 7 publications

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“…2 The finding that the in vitro addition of high-MW HA to equine SF that is deficient in lubricating ability restores lubricant function suggests that intra-articular lubricant supplementation may help maintain and/or restore the boundary lubrication function of SF following arthroscopic joint repair surgery. While there is a vast amount of information regarding the possible mechanisms of action of HA 17 and the use of HA as a clinical treatment for osteoarthritis, 39 there is limited information on clinical studies of HA as a treatment for acute joint injury 10,42 or cartilage repair. 31 To evaluate a possible role of HA injections to augment lubrication after surgery for acute knee injury, the time-dependent concentrations of HA and its contribution to cartilage lubrication needs to be clarified at various times postsurgery.…”

Section: Discussionmentioning

confidence: 99%

“… 22 Cells isolated in this manner have been previously shown to have chondrogenic and osteogenic differentiation potential. 22 Fibrinogen and platelets were harvested from horse plasma 28 and formed into a fibrin-based scaffold on injection with bovine thrombin to achieve a final platelet concentration of 10 10 /mL. For each horse ( Figure 1 ), 1 patellofemoral joint (side randomized) was treated with fibrin (n = 12), while the contralateral joint was treated with F + MSC (n = 12).…”

Section: Methodsmentioning

confidence: 99%

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Synovial Fluid Lubricant Properties Are Transiently Deficient After Arthroscopic Articular Cartilage Defect Repair With Platelet-Enriched Fibrin Alone and With Mesenchymal Stem Cells

Grissom

Temple-Wong

Adams

et al. 2014

Orthopaedic Journal of Sports Medicine

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Background Following various types of naturally-occurring traumatic injury to an articular joint, the lubricating ability of synovial fluid is impaired, with a correlated alteration in the concentration and/or structure of lubricant molecules, hyaluronan and proteoglycan-4. However, the effect of arthroscopic cartilage repair surgery on synovial fluid lubricant function and composition is unknown. Hypothesis Arthroscopic treatment of full-thickness chondral defects in horses with (1) platelet-enriched fibrin or (2) platelet-enriched fibrin+mesenchymal stem cells leads to equine synovial fluid with impaired lubricant function and hyaluronan and proteoglycan-4 composition. Study Design Controlled Laboratory Study. Methods Equine synovial fluid was aspirated from normal joints at a pre-injury state (0 days) and at 10 days and 3 months following fibrin or fibrin+mesenchymal stem cell repair of full thickness chondral defects. Equine synovial fluid samples were analyzed for friction-lowering boundary lubrication of normal articular cartilage (static and kinetic friction coefficients) and concentrations of hyaluronan and proteoglycan-4, as well as molecular weight distribution of hyaluronan. Experimental groups deficient in lubrication function were also tested for the ability of exogenous high-molecular weight hyaluronan to restore lubrication function. Results Lubrication and biochemical data varied with time after surgery but generally not between repair groups. Relative to pre-injury, kinetic friction was higher (+94%) at 10 days but returned to baseline levels at 3 months while static friction was not altered. Correspondingly, hyaluronan concentration was transiently lower (-64%) and shifted towards lower molecular weight forms, while proteoglycan-4 concentration was increased (+210%) in 10-day samples relative to pre-injury levels. Regression analysis revealed that kinetic friction decreased with increasing total and high molecular weight hyaluronan. Addition of high molecular weight hyaluronan to bring 10-day hyaluronan levels to 2.0mg/ml restored kinetic friction to pre-injury levels. Conclusion Following arthroscopic surgery for cartilage defect repair, synovial fluid lubrication function is transiently impaired, in association with decreased hyaluronan concentration. This functional deficiency in synovial fluid lubrication can be counteracted in vitro by addition of high molecular weight hyaluronan. Clinical Relevance Synovial fluid lubrication is deficient shortly following arthroscopic cartilage repair surgery, and supplementation with high molecular weight hyaluronan may be beneficial.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Synovial Fluid Lubricant Properties Are Transiently Deficient After Arthroscopic Articular Cartilage Defect Repair With Platelet-Enriched Fibrin Alone and With Mesenchymal Stem Cells

Grissom

Temple-Wong

Adams

et al. 2014

Orthopaedic Journal of Sports Medicine

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“…HA mitigated inflammation, provided pain relief (assessed by VAS), and enhanced range of motion. Other pilot studies have also demonstrated benefit of HA therapy in improving function and/or reducing pain in patients following knee immobilization 67 or acute knee injury 68 , and in the treatment of inflammatory arthropathies 69 . Definitive RCTs in each of these indications are currently in progress.…”

Section: Discussionmentioning

confidence: 99%

Hyaluronans in the treatment of osteoarthritis of the knee: evidence for disease-modifying activity

Goldberg

Buckwalter

2005

Osteoarthritis and Cartilage

236

174

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“…Pietrogrande showed a pain reduction from visual analogue scale values of 6 cm down to 2 cm 60 days after the intra-articular injections of HA 11 . Di Marco and Letizia found a reduction of weight-bearing pain from 6.7 to 4.7 cm following treatment with HA 13 . According to a recent review, intra-articular injection of HA reduced knee pain in patients with tibiofemoral disease by 20e40% over 6e12 months 18 .…”

Section: Introductionmentioning

confidence: 95%

Efficacy of intra-articular hyaluronic acid in patients with osteoarthritis of the ankle: a prospective study

Sun

Chou

Hsu

et al. 2006

Osteoarthritis and Cartilage

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Hyaluronic Acid in the Treatment of Pain Due to Knee Joint Immobilisation

Cited by 9 publications

References 7 publications

Synovial Fluid Lubricant Properties Are Transiently Deficient After Arthroscopic Articular Cartilage Defect Repair With Platelet-Enriched Fibrin Alone and With Mesenchymal Stem Cells

Synovial Fluid Lubricant Properties Are Transiently Deficient After Arthroscopic Articular Cartilage Defect Repair With Platelet-Enriched Fibrin Alone and With Mesenchymal Stem Cells

Hyaluronans in the treatment of osteoarthritis of the knee: evidence for disease-modifying activity

Efficacy of intra-articular hyaluronic acid in patients with osteoarthritis of the ankle: a prospective study

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