CURRENT ASPECTS OF HYALURONATE TREATMENT IN KNEE OSTEOARTHRITIS
Abstract:
Osteoarthritis (OA) involves pathological changes in all joint tissues, including cartilage
degradation and synovitis. Synovial inflammation is significantly associated with pain severity and
incidence of OA. Apparently, synovitis also plays an active role in the initiation and progression of
cartilage erosion in gonarthrosis by direct secretion of catabolic enzymes as well as factors that
stimulate the catabolic activity of chondrocytes. New studies demonstrate the presence of cytokines and
chemokines in the articular synovial fluid. Among arthroses, the incidence of knee localized OA is the
largest. In early stages, first-line treatment consists of adjusting the lifestyle, weight loss
recommendations, symptomatic treatment with non-steroidal anti-inflammatory drugs and intraarticular
(IA) administration of corticosteroids (CS). Intra-articular injection therapy with hyaluronic
acid (IA HA) is a viable option after using the first-line methods. Efficacy of hyaluronan is debated even
20 years after its implementation on the world market. Recently conducted systematic reviews and metaanalytical
studies compare the effectiveness of IA HA injections with placebo treatment. Results
advocate for hyaluronic acid.
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