Viscosupplementation for the treatment of osteoarthritis of the knee

Bellamy, Nicholas; Campbell, Jane; Robinson, Vivian; Gee, Travis; Bourne, Robert B.; Wells, George A.

doi:10.1002/14651858.cd005321.pub2

Cited by 431 publications

(251 citation statements)

References 150 publications

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“…Favorable outcomes with viscosupplementation of hyaluronate (HA) and its derivatives have been reported for pain and function associated with knee osteoarthritis (OA) (9), whereas few reports on the use of HA injections in the shoulder have been published (10,11). Recently, the results of the first large, multicenter, double-blind, randomized, saline-controlled study have shown that injection of HA is effective for the treatment of chronic painful shoulder, particularly in patients with glenohumeral OA (12).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effects of hyaluronate injections in patients with chronic painful shoulder: A meta‐analysis of randomized controlled trials

Saito¹,

Furuya²,

Kotake³

2010

Arthritis Care & Research

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Objective. To elucidate the therapeutic efficacy and safety of injection of hyaluronate (HA) for chronic painful shoulder. Methods. The meta-analysis comprised randomized controlled trials (RCTs) that compared the efficacy of HA injections with that of a placebo. Articles were retrieved through systematic searches of databases, including Medline, EMBase, and Japana Centra Revuo Medicina. The outcome end points were classified into 5 categories: pain, shoulder range of motion (ROM), total functional score, comparison between HA and steroid injections, and HA safety. The primary outcome measures of the efficacy of HA injections were the standardized mean differences (SMDs) and the relative risk (RR) or odds ratio (OR) between HA and placebo groups. Conclusion. This meta-analysis confirms that HA injection is effective in relief of pain and is a safe alternative therapy for chronic painful shoulder.

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Section: Introductionmentioning

confidence: 99%

Therapeutic effects of hyaluronate injections in patients with chronic painful shoulder: A meta‐analysis of randomized controlled trials

Saito¹,

Furuya²,

Kotake³

2010

Arthritis Care & Research

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“…Balazs [6] and Balaz and Denlinger [7] proposed correcting OA synovial fluid (SF) disorders by injecting high-molecular-weight hyaluronan acid (HA) and thereby introduced the concept of viscosupplementation (VS). VS by intraarticular injections of HA is used for reducing pain and improving joint mobility in patients with OA of the knee and other synovial joints [5,11] by restoring SF rheologic properties affected in OA. HA is a natural polysaccharide existing in the animal body [28,31,35] and especially in the joints where it plays an important role in lubrication, shock absorption, and viscoelastic behavior of the synovial fluid [8,17,22,39,58].…”

Section: Introductionmentioning

confidence: 99%

Rheologic Behavior of Osteoarthritic Synovial Fluid after Addition of Hyaluronic Acid: A Pilot Study

Mathieu

Conrozier

Vignon

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Viscosupplementation is a symptomatic treatment of osteoarthritis (OA) intended to restore rheologic homeostasis of the synovial fluid by injecting hyaluronic acid intraarticularly. Despite the long history of this therapy, little is known about its mechanisms of action and differences between commercial preparations. We investigated the rheologic behavior of OA synovial fluid with time, when stored at 4°C, before and after the addition of two hyaluronic acid commercial preparations (linear and cross-linked). Thirteen OA synovial fluids were stored at 4°C and assayed using steric exclusion chromatography, which allows hyaluronic acid to be separated from the remaining pool of proteins and its molecular weight and concentration to be determined without any pretreatment and calibration. The synovial fluid rheology also was studied in vitro, before and after addition of two viscosupplements, over 6 weeks. The non-Newtonian behavior of synovial fluid throughout followup appears to be the result of loose interactions between proteins and hyaluronic acid. When mixed with the linear hyaluronic acid, synovial fluid becomes less non-Newtonian whereas the non-Newtonian behavior was reinforced when mixed with the cross-linked hyaluronic acid. The rheology was nearly unchanged for all synovial fluids over 6 weeks. Our preliminary trial shows it is possible to study synovial fluid, stored at 4°C, over a long time and suggests the enzymatic degradation of hyaluronic acid is negligible under these experimental conditions.

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“…The MW and residence time in the joint varies between products, and their recommended dosing regimens for the treatment of symptomatic knee OA range from 1 to 5 injections at weekly intervals [6]. The number of injections required to achieve eYcacy is inversely related to the MW of the preparation used and, consequently, to the residence time in the joint.…”

Section: Introductionmentioning

confidence: 99%

Prospective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study

Conrozier

Jerosch

Beks

et al. 2008

Arch Orthop Trauma Surg

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Viscosupplementation for the treatment of osteoarthritis of the knee

Cited by 431 publications

References 150 publications

Therapeutic effects of hyaluronate injections in patients with chronic painful shoulder: A meta‐analysis of randomized controlled trials

Therapeutic effects of hyaluronate injections in patients with chronic painful shoulder: A meta‐analysis of randomized controlled trials

Rheologic Behavior of Osteoarthritic Synovial Fluid after Addition of Hyaluronic Acid: A Pilot Study

Prospective, multi-centre, randomised evaluation of the safety and efficacy of five dosing regimens of viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study

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