Intra-articular hyaluronan injections in the treatment of osteoarthritis of the knee: a randomised, double blind, placebo controlled multicentre trial. Hyaluronan Multicentre Trial Group.

Abstract

Objective-To assess the effects of intraarticular injections of hyaluronan on symptoms ofknee osteoardtritis (OA).

Hyaluronic acid inhibits mRNA expression of proinflammatory cytokines and cyclooxygenase‐2/prostaglandin E2 production via CD44 in interleukin‐1‐stimulated subacromial synovial fibroblasts from patients with rotator cuff disease

“…29 In clinical practice, however, intraarticular HA injection is well tolerated, and no adverse effects have been reported in most previous studies. [12][13][14][15][30][31][32] Different sets of experiments will be required to confirm our data and verify our working hypothesis.…”

“…Although HA is widely used in the treatment of OA, [12][13][14] the nature of its anti-inflammatory mechanism remains poorly understood. 11 Similarly, a clinical benefit of HA in rotator cuff disease was demonstrated by Shibata et al, 15 although little is known about its anti-inflammatory effect in the disease.…”

“…11 Intraarticular HA injection is used to treat knee OA, and its therapeutic efficacy has been verified. [12][13][14] In rotator cuff disease, Shibata et al uniquely demonstrated that HA injection is an effective conservative procedure, 15 although the mechanism of its anti-inflammatory effect is not fully understood.…”

Intra-Articular Injections for the Treatment of Osteoarthritis: Focus on the Clinical Use of Several Regimens

“…One early placebo-controlled trial indicated increased benefit among older patients with more significant osteoarthritis. (Lohmander et al, 1996) In another study, Dahlberg et al evaluated a group of patients with normal radiographs and early arthritic changes observed at arthroscopy. They reported no significant benefit from 5 weekly injections of sodium hyaluronate (compared with placebo) (Dahlberg et al, 1994).…”

Intra-articular Injection of Hyaluronan Diminishes Loss of Chondrocytes in a Rat Immobilized-Knee Model

“…This is one of the main reasons why intra-articular HA injection has been widely accepted as a treatment of OA (Goldberg and Buckwalter 2005). Practically, many clinical investigations of HA injections showed the efficacy on symptoms of OA patients (Lohmander et al 1996;Altman and Moskowitz 1998;Brandt et al 2001). Joint immobilization is an essential treatment in daily examinations to decrease pain and joint damage (Salter and Field 1960;Trudel et al 2000), but it also causes degeneration or atrophy of the articular cartilage (Trudel et al 2005).…”