Intraarticular Injection of High-Molecular Hyaluronic Acid:<i>An Experimental Study on Normal Adult Rabbit Knee Joints</i>

Wigren, Anders; Wik, Owe; Falk, John

doi:10.3109/17453677608988724

Cited by 18 publications

(9 citation statements)

References 12 publications

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“…Hyaluronate, which is also a biodegradable mucopolysaccharide and well known as one of the main components of synovial fluid, has also been used experimentally to prevent peritendinous adhesion. 15 However, in contrast to alginate, hyaluronate is rapidly broken down in the human body by hyaluronidase and disappears within 72 h. 19 In summary, the results of the present study suggest that alginate solution is an effective material for inhibition of peritendinous adhesion, and that its application represents a promising approach for treating tendon injury. Although alginate solution showed a favorable antiadhesive effect in our rabbit tendon model, further studies are required to determine suitable concentration and viscosity in clinical use.…”

Section: Discussionmentioning

confidence: 80%

Modulation of peritendinous adhesion formation by alginate solution in a rabbit flexor tendon model

Namba

Shimada²,

Saito

et al. 2006

J Biomed Mater Res

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To examine the antiadhesive effect of an alginate solution following tendon surgery, unilateral subtotal laceration of the flexor digitorum communis tendon was created in one hind limb while the other side was left intact in 32 Japanese white rabbits. The lesion was coated with alginate solution in 16 animals and not coated in the other 16. Degree of adhesion formation was assessed histologically and biomechanically by measuring the flexion angle of the first toe when the flexor digitorum tendon was pulled with a specified force at 4 weeks postoperatively. When compared with the control group, the alginate-treated group demonstrated significantly greater toe flexion, with less scar tissue formation at the repair site. Histologically, complete tendon healing with longitudinal remodeling of collagen fibers was observed in the alginate-treated group, while a random pattern of fibers was observed in the control group. Reduction in adhesion formation using alginate solution represents a novel strategy for the management of tendon injury and repair in the clinical setting.

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Section: Discussionmentioning

confidence: 80%

Modulation of peritendinous adhesion formation by alginate solution in a rabbit flexor tendon model

Namba

Shimada²,

Saito

et al. 2006

J Biomed Mater Res

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“…Gelation (or cross-linking) causes the decrement of free carboxylic groups in the alginate chain, as discussed earlier, even though the alginate dilute gel with mild cross-linking still has free carboxylic groups for muco-adhesiveness. It is well known that the alginate has relatively long bioabsorption time in the body because of lack of the suitable enzymes [42] and, therefore, the un-cross-linked alginate can remain at the application site during the time required for the tissue adhesion prevention and wound healing. In contrast to alginate, other polysaccharides, like hyaluronate, have been reported to be rapidly resorbed in the body and disappear within a few days [42,43].…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that the alginate has relatively long bioabsorption time in the body because of lack of the suitable enzymes [42] and, therefore, the un-cross-linked alginate can remain at the application site during the time required for the tissue adhesion prevention and wound healing. In contrast to alginate, other polysaccharides, like hyaluronate, have been reported to be rapidly resorbed in the body and disappear within a few days [42,43]. The poor anti-tissue adhesion behavior of the Interceed™ group in our study may be explained by the fast clearance of the film caused by hemorrhage from the injured tissue.…”

Section: Discussionmentioning

confidence: 99%

Alginate Film as a Novel Post-Surgical Tissue Adhesion Barrier

Cho

Lee

2010

Journal of Biomaterials Science, Polymer Edition

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In this study, we focused on alginate as a physical tissue adhesion barrier material. The alginate has a muco-adhesive property in the solid state and becomes a viscous slippery gel-like solution in the dissolved state. We hypothesized that the alginate film without cross-linking can be a good candidate as a tissue adhesion barrier. The un-cross-linked alginate film may stably adhere onto a wound owing to its muco-adhesive property and, thus, does not need suturing to fix it, and then the film may slowly change into a slippery gel by hydration when in contact with body fluid and, thus, effectively separate the wound from the surrounding tissue without adhesion. To verify our hypothesis, we fabricated a un-cross-linked alginate film and its potential as a tissue adhesion barrier was evaluated through the comparison with various types of alginate (viscous solution and gel as well as cross-linked film) and a commercialized tissue adhesion barrier, Interceed, by the investigation of post-surgical peritoneal adhesion using a rat model. From the animal study, it was observed that the un-cross-linked alginate film was more effective for the prevention of peritoneal tissue adhesion than other types of alginates, including the commercialized one, probably owing to its unique muco-adhesive property (providing residence stability without suturing at the injured site) and lubricant property (by hydration in contact with body fluid) during wound healing. The un-cross-linked alginate film also showed a low inflammatory response and did not lead to specific histological influence during the wound healing. From these observations, the un-cross-linked alginate film is expected to be a simple and efficient tissue adhesion barrier applicable to various injury tissues.

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“…Although the effects of arthrotomy on cartilage metabolism have been well documented (1 1,23, 26,40,42,43,[54][55][56]65), there has been limited (27,39,46,68,86) recognition that violation of the synovial membrane by IA injections may also be deleterious to the short term (<14 days) integrity of matrix PGs.…”

Section: Discussionmentioning

confidence: 99%

“…Although an early report by Key (46) that multiple IA iajections of sterile saline into rabbit joints produced arthritic-like changes has been re-cently substantiated (27,68,81,86), the effects of such treatment on proteoglycan (PG) aggregation in articular cartilage have not been previously described. In this paper we report the results of our studies on PG aggregation and release in culture from articular cartilage of rabbit knee joints following one, two, or three consecutive IA injections of sterile saline.…”

mentioning

confidence: 99%

Microinjury to the synovial membrane may cause disaggregation of proteoglycans in rabbit knee joint articular cartilage

Frost

Ghosh

1984

Journal Orthopaedic Research

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Proteoglycans (PGs) isolated from articular cartilage (AC) of mature rabbits subjected to two or more consecutive intraarticular (IA) injections of sterile saline 24 h apart showed an aggregation defect in the presence of excess hyaluronic acid (HA). Although the PG contents of experimental and control cartilages were indistinguishable, a higher proportion of PGs were extractable from the 3 X IA tissues, as assessed by uronic acid analysis. Proteoglycans from experimental and control cartilages when examined by Sepharose CL-2B chromatography showed two subunit populations, the smaller (KAV = 0.70) containing more ketatan sulphate than the larger (KAV = 0.31). Cultures of AC from IA joints released more 35SO4-labelled PGs into the media over 72 h than control tissues and consisted mainly of PG degradation products although 20% could aggregate in the presence of HA. Examination of PG aggregation 2 weeks after 2 X IA or 3 X IA injections showed that the defect initiated was still present; however, cartilage of immature rabbits was not affected by the 2 X IA procedure.

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Intraarticular Injection of High-Molecular Hyaluronic Acid:An Experimental Study on Normal Adult Rabbit Knee Joints

Cited by 18 publications

References 12 publications

Modulation of peritendinous adhesion formation by alginate solution in a rabbit flexor tendon model

Modulation of peritendinous adhesion formation by alginate solution in a rabbit flexor tendon model

Alginate Film as a Novel Post-Surgical Tissue Adhesion Barrier

Microinjury to the synovial membrane may cause disaggregation of proteoglycans in rabbit knee joint articular cartilage

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