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Daniele Clementi, Riccardo D'Ambrosi, Paride Bertocco, Miguel Simon Bucci, Carlo Cardile, Paolo Ragni, Graziella Giaffreda, Vincenza Ragone
BACKGROUND: Viscosupplementation with hyaluronic acid (HA) is increasingly used for the treatment of hip osteoarthritis (OA). The purpose of this study was to compare the efficacy of intra-articular injections of an ultra-high molecular weight viscosupplement (UHMW-HA, Fermathron S) with a medium molecular weight hyaluronan (MMW-HA, Hyalubrix 60) in hip OA. METHODS: Fifty-four patients with hip OA grade 3 on the Kellgren/Lawrence scale were randomized. All infiltrations were performed under ultrasound guidance...
November 21, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Edward D Bonnevie, Devis Galesso, Cynthia Secchieri, Lawrence J Bonassar
Hyaluronic acid (HA) is widely injected as a viscosupplement in the treatment of osteoarthritis. Despite its extensive use, it is not currently known if cartilage degradation alters how HA-based solutions lubricate the articular surface. In this study we utilized a model of cartilage degradation by IL-1β along with a recently developed framework to study role of cartilage degradation on lubrication by clinically-approved HA-based lubricants with high viscosities. Cartilage explants were cultured up to 8 days with 10 ng/ml IL-1β...
October 25, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Benjamin von Lospichl, Shabnam Hemmati-Sadeghi, Pradip Dey, Tilo Dehne, Rainer Haag, Michael Sittinger, Jochen Ringe, Michael Gradzielski
Osteoarthritis (OA) is a disabling condition especially in the elderly population. The current therapeutic approaches do not halt the OA progression or reverse joint damage. In order to overcome the problem of rapid clearance of hyaluronic acid (HA), a standard viscosupplement for OA, we investigated the rheological properties of a relatively non-degradable dendritic polyglycerol sulfate (dPGS) hydrogel to determine a suitable concentration for intra articular injections that mimics HA in terms of its viscoelastic and mechanical properties...
November 1, 2017: Colloids and Surfaces. B, Biointerfaces
Thierry Conrozier
Viscosupplementation with intra-articular injections of hyaluronic acid is recommended as a second line treatment for knee OA, after failure of non-pharmacological modalities and usual pain killers. Nevertheless there is still controversies regarding clinical relevance of its effects. Research is looking at the best means to improve the performance of viscosupplementation in order to obtain a faster, more sustainable and more marked effect. Antioxidants have been assessed in combination with hyaluronic acid because the injected hyaluronate is rapidly degraded by the reactive oxygen species present in large amounts in the OA synovial fluid, limiting its residence time into the joint...
July 10, 2017: Current Rheumatology Reviews
David Bar-Or, Leonard T Rael, Edward N Brody
BACKGROUND: Osteoarthritis of the knee (OAK) is a severe debilitating condition characterized by joint pain, stiffness, and resultant limited mobility. In recent years, intra-articular (IA) injections have been used to relieve symptoms and have succeeded to varying degrees either with sodium hyaluronate preparations or with a biologic. OBJECTIVE: The objective of this review is to evaluate multiple studies that demonstrate some relief from the symptoms of OAK in the saline arm of various clinical trials...
2017: Open Rheumatology Journal
Marie Bossert, Daniel Boublil, Jean-Marc Parisaux, Ana-Maria Bozgan, Emmanuel Richelme, Thierry Conrozier
BACKGROUND: The objective of this survey was to assess retrospectively the interest of performing viscosupplementation using imaging guidance in patients suffering from ankle osteoarthritis (OA). PATIENTS AND METHODS: This is a multicenter retrospective survey using a standardized questionnaire. Fifty patients suffering from ankle OA and treated, in daily clinical practice, with a single intra-articular injection of a novel viscosupplement made of a combination of a non-animal cross-linked hyaluronan and mannitol, HANOX M-XL, were included in the survey...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Anwar Madkhali, Michael Chernos, Samin Fakhraei, Dana Grecov, Ezra Kwok
BACKGROUND: Osteoarthritis is a common, localized joint disease that causes pain, stiffness and reduced mobility. The effects of osteoarthritis on the extensional rheology of synovial fluid in the knees are not fully understood and consequently require further study. OBJECTIVE: The purpose of this work is to study the extensional rheology of osteoarthritic synovial fluid and to investigate a possible correlation between synovial fluid protein concentration and extensional rheology...
November 9, 2016: Biorheology
Anwar Madkhali, Michael Chernos, Dana Grecov, Ezra Kwok
BACKGROUND: Osteoarthritis is a common, localized joint disease that causes pain, stiffness and reduced mobility. Osteoarthritis is particularly common in the knees. The effects of osteoarthritis on the rheology of synovial fluid in the knees are not fully understood and consequently require further study. OBJECTIVE: The purpose of this study is to investigate the effects of protein content on synovial fluid shear rheology. A secondary study outcome will include study of the temperature dependence of synovial fluid behaviour...
November 9, 2016: Biorheology
Thierry Conrozier, Ana-Maria Bozgan, Marie Bossert, Maxime Sondag, Anne Lohse-Walliser, Jean-Charles Balblanc
OBJECTIVES: The objective of this study is to obtain pilot data from daily practice conditions of a viscosupplement made of a cross-linked high-molecular-weight hyaluronic acid (HA) combined with mannitol in patients with knee osteoarthritis (KOA). METHODS: The data of 40 consecutive patients, 29 women and 11 men, who were prospectively followed up for 6 months, using a standardized procedure, were retrospectively analyzed. All patients have received a single intra-articular injection of HAnox-M-XL (4...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Thierry Conrozier, Florent Eymard, Naji Afif, Jean-Charles Balblanc, Virginie Legré-Boyer, Xavier Chevalier
BACKGROUND: To compare both safety and efficacy of a novel intra-articular viscosupplement made of intermediate molecular weight (MW) hyaluronic acid (HA) mixed with high concentration of mannitol with a marketed high MW HA, in patients with knee osteoarthritis (OA). METHODS: Patients with symptomatic knee OA, with radiological OARSI grades 1 to 3, were enrolled in a controlled, double-blind, parallel-group, non-inferiority trial. They were randomized to receive three intra-articular injections, at weekly intervals, of either HAnOX-M made of a combination of HA (MW one to 1...
October 2016: Knee
Fabrizio Russo, Matteo D'Este, Gianluca Vadalà, Caterina Cattani, Rocco Papalia, Mauro Alini, Vincenzo Denaro
INTRODUCTION: Osteoarthritis (OA) is the most common musculoskeletal disease. Current treatments for OA are mainly symptomatic and inadequate since none results in restoration of fully functional cartilage. Hyaluronic Acid (HA) intra-articular injections are widely accepted for the treatment of pain associated to OA. The goal of HA viscosupplementation is to reduce pain and improve viscoelasticity of synovial fluid. Platelet-rich plasma (PRP) has been also employed to treat OA to possibly induce cartilage regeneration...
2016: PloS One
Mohammad Haris, Anup Singh, Sanjana Reddy, Puneet Bagga, J Bruce Kneeland, Fotios P Tjoumakaris, Hari Hariharan, Francesco M Marincola, Ravinder Reddy
BACKGROUND: Osteoarthritis (OA) is characterized by progressive loss of cartilage in joints, and is a major cause of pain and disability, and imposes significant health care expense. New therapies are being developed to treat the symptomatic effect of OA, one of which is intra-articular injection of viscosupplementations of different forms of hyaluronic acid (HA). The current study evaluates the chemical exchange saturation transfer (CEST) effect from two popular viscosupplementations [Hylan gf-20 (Synvisc) and hyaluronan (Orthovisc)] by targeting the exchangeable hydroxyl protons present on these molecules (ViscoCEST)...
April 12, 2016: Journal of Translational Medicine
Thierry Conrozier, Jeremy Patarin, Pierre Mathieu, Marguerite Rinaudo
BACKGROUND: Viscosupplementaion by intra-articular injection of hyaluronic acid (HA) is a therapeutic modality for treating osteoarthritis of the knee, of the hip and less frequently of other joints. During viscosupplementation, it is usual to inject other drugs, without knowing whether this association may have a deleterious effect thereon. The rheological properties of a viscosupplement are highly dependent on the product [molecular weight × concentration] of HA. Therefore, any reduction of its viscoelastic properties is related either to a decrease of its concentration or/and of its molecular weight...
2016: SpringerPlus
Mauro Pavan, Devis Galesso, Cynthia Secchieri, Cristian Guarise
Extracellular matrix (ECM) degradation, one of the main features of osteoarthritis, is driven by at least two major classes of enzymes: matrix metalloproteases (MMPs) and hyaluronidases. Among certain glycosaminoglycans, including natural and chemically cross-linked HAs, which are currently used as viscosupplements, the hyaluronic acid (HA) alkyl-amides (Hyadd) were here selected as the strongest MMP and hyaluronidase inhibitors. We used C. histolyticum collagenase (ChC) and bovine testicular hyaluronidase (BTH) as representative models of human MMPs and hyaluronidases, respectively...
March 2016: International Journal of Biological Macromolecules
Sandra Kienle, Kathrin Boettcher, Lorenz Wiegleb, Joanna Urban, Rainer Burgkart, Oliver Lieleg, Thorsten Hugel
The exceptional tribological properties of articular cartilage are still far from being fully understood. Articular cartilage is able to withstand high loads and provide exceptionally low friction. Although the regeneration abilities of the tissue are very limited, it can last for many decades. These biomechanical properties are realized by an interplay of different lubrication and wear protection mechanisms. The deterioration of cartilage due to aging or injury leads to the development of osteoarthritis. A current treatment strategy focuses on supplementing the intra-articular fluid with a saline solution containing hyaluronic acid...
September 18, 2015: Journal of Biomechanics
Yves Henrotin, Raghu Raman, Pascal Richette, Hervé Bard, Jörg Jerosch, Thierry Conrozier, Xavier Chevalier, Alberto Migliore
Viscosupplementation (VS) with hyaluronic acid is currently used by physicians to treat osteoarthritis. However, many aspects of this treatment remain questionable and subject of controversy. A group of 8 experts in this field, from European countries, met to debate on 24 statements previously listed by the group members. Based on an extensive research of the literature and expert opinion, a consensus position has been proposed for each statement. Agreement was achieved on some recommendations. In particular, the expert achieved unanimous agreement in favor of the following statements: VS is an effective treatment for mild to moderate knee OA; VS is not an alternative to surgery in advanced hip OA; VS is a well-tolerated treatment of knee and other joints OA; VS should not be used only in patients who have failed to respond adequately to analgesics and NSAIDs; VS is a "positive" indication but not a "lack of anything better" indication; the dosing regimen must be supported by evidence-based medicine; cross-linking is a proven means for prolonging IA residence time of HA; the best approach to inject accurately knee joint is the lateral mid-patellar one; when VS is performed under fluoroscopy, the amount of radiopaque contrast agent must be as low as possible to avoid viscosupplement dilution...
October 2015: Seminars in Arthritis and Rheumatism
John Posnett, Sanjeev Dixit, Brooks Oppenheimer, Sven Kili, Nazanin Mehin
PURPOSE: To review treatments for osteoarthritis of the knee (OAK) received by patients across five European countries, and to obtain patients' perceptions and willingness to pay for current treatments. PATIENTS AND METHODS: A prospective, internet-based, double-blind survey of adults with OAK was conducted in France, Germany, Italy, Spain, and the United Kingdom. The questionnaire included questions about diagnosis, treatment history, and perceptions of OAK treatments, followed by a discrete choice-based conjoint exercise to identify preferred attributes of OAK treatments, evaluating 14 sets of four unbranded products...
2015: Patient Preference and Adherence
Q Y Yeo, D C Lye, S S Sathappan Ss
Intra-articular therapies, such as steroid injection, viscosupplement injection and acupuncture, are common non-surgical options for patients with osteoarthritis of the knee. With any intra-articular injection or acupuncture procedure, there is a potential for inoculation with bacteria leading to possible knee infection. The authors report a patient who incurred an acute infection found after a total knee arthroplasty attributed to prior acupuncture procedure done as part of conservative treatment.
February 2015: Medical Journal of Malaysia
Vibeke Strand, Louis F McIntyre, William R Beach, Larry E Miller, Jon E Block
BACKGROUND: Intra-articular injection of hyaluronic acid is a common, yet controversial, therapeutic option for patients with knee osteoarthritis (OA). The purpose of this research was to determine the safety and efficacy of US-approved viscosupplements for symptomatic knee OA. METHODS: We searched MedLine and EMBase for randomized, sham-controlled trials evaluating safety and/or clinical efficacy of US-approved viscosupplements in patients with symptomatic knee OA...
2015: Journal of Pain Research
H R Shao, Y Jin, G Y Han, P Jiang, X Q Zhu, F Liu, Z G Song, M Li, P X Ling
BACKGROUND: Injection of xanthan gum (XG) has been demonstrated to reduce the symptoms and progression of osteoarthritis (OA) in experimental models. Due to its high viscosity and stability, it may restore the rheological homeostasis of osteoarthritic synovial fluid (SF), and avoid numerous intra-articular injections. OBJECTIVE: The present study investigated the effect of XG on the rheological properties of SF, and determined its residence time in the rabbit joint cavity...
2014: Biorheology
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