scholarly journals The safety and efficacy of intra-articular dual molecular weighted hyaluronic acid in the treatment of knee osteoarthritis: the I.D.E.H.A. study

2013 ◽  
Vol 5 (4) ◽  
pp. 33 ◽  
Author(s):  
Xuming Shen ◽  
Romeo Gatti
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Concomitant Medication ◽  
Therapeutic Effects ◽  
Joint Function ◽  
Beneficial Effects ◽  
The Third ◽  
Lequesne Index ◽  
Concomitant Medications

In clinical practice viscosupplementation with hyaluronic acid (HA) is common for the treatment of degenerative osteoarthritis (OA). Both molecular weight and concentration of HA have significant impact on its rheological properties, which in turn affects its therapeutic effects. The objective of this study is to evaluate the effectiveness of a double HA preparation for the treatment of knee osteoarthritis with respect to pain reduction, joint function improvement and concomitant medication consumption reduction. One thousand and fourteen patients (521 males and 693 females) with a mean age of 62.4 years old, suffering from OA of the knee, were enrolled into this study. All patients received two intra-articular injections one week apart and a third injection one month after the second one. Concomitant medication was recorded and evaluated at follow up visits. Evaluation was performed at baseline, day 30 and day 180, on several parameters: knee pain by visual analog scale (VAS) 0-10 cm, Lequesne Index, and consumption of concomitant medications including non-steroidal anti-inflammatory drugs, analgesics and chondoprotective supplementations. A statistically significant reduction in pain VAS score was recorded at D30 (38.01±17.68; P<0.01) before the third injection, and D180 (25.91±15.33; P<0.01) check-points comparing to baseline (67.12±15.99). Similarly, remarkable reduction in Lequesne Index was shown at D30 (5.91±4.01; P<0.01) in 1214 patients before the third injection, and D180 (3.59±3.45; P<0.01) (with 938 patients) when compared to the baseline (11.60±5.13). Patients also consumed less concomitant medications after the treatment course. The beneficial effects were maintained for up to six months. Intra-articular injection of a double HA preparation of low molecular weight and high molecular weight of different concentrations was well tolerated, and generated satisfactory results in terms of pain control, joint function improvement and concomitant medication reduction for the management of knee OA.

scholarly journals Efficacy of intra-articular hyaluronic acid injections in the rehabilitation programme of Knee Osteoarthritis

2019 ◽  
Vol 10 (Vol.10, No.3) ◽  
pp. 225-230 ◽  
Author(s):  
Ilie ONU ◽  
Daniela MATEI ◽  
Anca GALACTION
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Therapeutic Effects ◽  
Key Words Knee ◽  
Beneficial Effects ◽  
Physiological Processes ◽  
Wear And Tear ◽  
Synovial Membrane Inflammation ◽  
Vital Component ◽  
Physical Therapies

Abstract Knee osteoarthritis (KOA) is a disease of wear and tear, leading to disability and ultimate surgical treatment. KOA has multiple etiologies and is considered a disorder of physiological processes that is manifested by progressive lesions of articular cartilage caused by chondrolysis, synovial membrane inflammation and subchondral osteophytes production. Modalities that limit the progression of the KOA and rehabilitation are a constant interest for clinicians and medical researchers. Various physical therapies and pharmacological strategies are currently used for pain management, with no clear benefit in terms of inhibiting disease progression. In this context, the use of exogenous hyaluronic acid (HA) (that is a vital component of the synovial fluid and involved in lubricating all synovial joints) has been explored as viable alternative to alleviate knee pain and temporarily restore knee function. In the following, we will review the use of HA injections associated with the physiotherapeutic recovery plan in the treatment of KOA. The therapeutic effects of the HA is still a matter of debate in the field, with no consensus being reached so far and thus, difficult to evaluate. However, much research has to be done to understand the therapeutic efficacy of HA alone or in combination with physical therapies and the role that other factors may play in unraveling its beneficial effects on the KOA. Key words: knee, osteoarthritis, hyaluronic acid, physiotherapy, rehabilitation,

Therapeutic Effects of High Molecular Weight Hyaluronic Acid in Severe Pseudomonas Aeruginosa Pneumonia in Ex Vivo Perfused Human Lungs

2021 ◽  
Author(s):  
Xiwen Zhang ◽  
Shinji Sugita ◽  
Airan Liu ◽  
Yoshifumi Naito ◽  
Wonjung Hwang ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Molecular Weight ◽  
Pseudomonas Aeruginosa ◽  
Hyaluronic Acid ◽  
High Molecular Weight ◽  
Bacterial Pneumonia ◽  
Ex Vivo ◽  
Therapeutic Effects ◽  
Human Lungs ◽  
Protein Permeability

Introduction: We previously reported that extracellular vesicles (EVs) released during Escherichia coli bacterial pneumonia were inflammatory, and administration of high molecular weight hyaluronic acid (HMW HA) suppressed several indices of acute lung injury (ALI) from Escherichia coli pneumonia by binding to these inflammatory EVs. The current study was undertaken to study the therapeutic effects of HMW HA in ex vivo perfused human lungs injured with Pseudomonas aeruginosa (PA)103 bacterial pneumonia. Methods: For lungs with baseline alveolar fluid clearance (AFC)<10%/h, HMW HA 1 or 2 mg was injected intravenously after 1 h (N = 4-9), and EVs released during PA pneumonia were collected from the perfusate over 6 h. For lungs with baseline AFC>10%/h, HMW HA 2 mg was injected intravenously after 1 h (N = 6). In vitro experiments were conducted to evaluate the effects of HA on inflammation and bacterial phagocytosis. Results: For lungs with AFC<10%/h, administration of HMW HA intravenously significantly restored AFC and numerically decreased protein permeability and alveolar inflammation from PA103 pneumonia but had no effect on bacterial counts at 6 h. However, HMW HA improved bacterial phagocytosis by human monocytes and neutrophils and suppressed the inflammatory properties of EVs released during pneumonia on monocytes. For lungs with AFC>10%/h, administration of HMW HA intravenously improved AFC from PA103 pneumonia but had no significant effects on protein permeability, inflammation or bacterial counts. Discussion: In the presence of impaired alveolar epithelial transport capacity, administration of HMW HA improved the resolution of pulmonary edema from Pseudomonas PA103 bacterial pneumonia.

scholarly journals High molecular weight intraarticular hyaluronic acid for the treatment of knee osteoarthritis: network meta-analysis

2019 ◽  
Vol 27 ◽  
pp. S503-S504
Author(s):  
C. Hummer ◽  
F. Angst ◽  
E. Schemitsch ◽  
C. Whittington ◽  
C. Manitt ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
High Molecular Weight ◽  
Meta Analysis

scholarly journals Efficacy of single high-molecular-weight versus triple low-molecular-weight hyaluronic acid intra-articular injection among knee osteoarthritis patients

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hasan Bahrami ◽  
Seyed Ahmad Raeissadat ◽  
Mohsen Cheraghi ◽  
Shahram Rahimi-Dehgolan ◽  
Adel Ebrahimpour
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
High Molecular Weight ◽  
Low Molecular Weight

scholarly journals Effects and safety of platelet-rich plasma (PRP) and hyaluronic acid (HA), alone and in combination, in the treatment of knee osteoarthritis: A systematic review and meta-analysis.

2020 ◽  
Author(s):  
Jinlong Zhao ◽  
Hetao Huang ◽  
Guihong Liang ◽  
Ling-feng Zeng ◽  
Weiyi Yang ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Womac Function ◽  
Lequesne Index

Abstract Background Studies have shown that the combined application of hyaluronic acid (HA) and platelet-rich plasma (PRP) can repair degenerated cartilage and delay the progression of knee osteoarthritis (KOA). The purpose of this study was to explore the efficacy and safety of PRP combined with HA in the treatment of KOA compared with intra-articular injection of PRP or HA alone. Methods The PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure (CNKI) databases were searched from inception to December 2019. Two orthopaedic surgeons conducted the literature retrieval and extracted the data. Outcome indicators include the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Lequesne Index, the visual analogue scale (VAS) for pain, and adverse events (AEs). Results Seven studies (5 randomized controlled trials, 2 cohort studies) with a total of 941 patients were included. In the VAS comparison after 6 months of follow-up, PRP combined with HA was more likely to reduce knee pain than PRP alone (standardized mean difference (SMD): -0.31; 95% confidence interval (CI): -0.55 to -0.06; P=0.01 <0.05). PRP combined with HA for KOA achieved better improvement in WOMAC Function Score (SMD: -0.32; 95% CI: -0.54 to -0.10) and WOMAC Total Score (SMD: -0.42; 95% CI: -0.67 to -0.17) at the 12-month follow-up than the application of PRP alone. In a comparison of Lequesne Index scores at a 6-month follow-up, PRP combined with HA improved knee pain scores more than PRP alone (SMD: -0.42; 95% CI: -0.67 to -0.17). In terms of AEs, PRP combined with HA was not significantly different from PRP or HA alone (P>0.05). Conclusions Compared with intra-articular injection of PRP alone, PRP combined with HA can improve WOMAC Function Scores, WOMAC Total Score, 6-month follow-up VAS ratings, and Lequesne Index scores. However, in terms of the incidence of AEs, PRP combined with HA was not significantly different from PRP or HA alone.

scholarly journals Intra-Articular Hyaluronic Acid as Treatment in Elderly and Middle-Aged Patients with Knee Osteoarthritis

2013 ◽  
Vol 7 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Demet Uçar ◽  
Demirhan Dıraçoğlu ◽  
Türker Süleyman ◽  
Nalan Çapan
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
The Elderly ◽  
Elderly Group ◽  
Middle Aged ◽  
Old Patients ◽  
Aged Group ◽  
The Third ◽  
Age Related ◽  
One Year

Introduction: Osteoarthritis is the most common age-related degenerative joint disease. It affects all the joints containing hyaline cartilage. Knee osteoarthritis is the most cumbersome in terms of prevalence and disability. The aim of this study to evaluate the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis with regard to joint pain and function, as well as patient satisfaction, assessed at one month and at one year, and by age group. Methods: In this prospective randomised study, 172 patients who were diagnosed knee OA and who received three consecutive intra-articular injections of HA weekly were included. Patients 65 years of age or older were accepted as the “elderly group”, and those under 65 were accepted as the “middle-aged group”. Clinical evaluations of efficacy and safety were conducted at the beginning of the study, one month after the third injection, and one year after the third injection. Results: In the two groups, the intragroup analysis revealed significant improvements following injection when compared with preinjection values. According to the last followup controls (after 12 months) in the middle-aged group, VAS activity pain, VAS rest pain, WOMAC physical function, and WOMAC pain values were found to be statistically lower when compared with pre-injection values. In the elderly group, no statistically significant differences were found between pre-injection and after 12 months. Conclusion: We can conclude that intra-articular joint HA injections are effective in both young and old patients with OA with regard to pain and functional status over a short-term period. Further, HA injections in patients younger than 65 years can be planned for a one-year period.

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