Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Sports Medicine
Published in: Sports Medicine 10/2005

01-10-2005 | Review Article

Potential Applications of Hyaluronans in Orthopaedics

Degenerative Joint Disease, Surgical Recovery, Trauma and Sports Injuries

Authors: Michael J. Axe, Dr Clarence L. Shields Jr

Published in: Sports Medicine | Issue 10/2005

Login to get access

Abstract

The use of hyaluronans for the treatment of pain in patients with osteoarthritis of the knee is well established. There are growing data to suggest that they may also alter the rate of disease progression. Reviewed here are preliminary data that also indicate a potential use for hyaluronans in the treatment of inflammatory arthropathies (e.g. acute joint trauma and fractures) that require long periods of immobilisation, and in tissue engineering for chondral defects. Although the trials that have investigated the use of hyaluronan therapy for the management of traumatic and degenerative musculoskeletal disorders seen in sports medicine have limitations in design and patient number, the results have been promising and suggest that larger controlled clinical trials are warranted.
Footnotes
1
1 The use of trade names is for product identification purposes only and does not imply endorsement.
 
Literature
1.
Goa KL, Benfield P. Hyaluronic acid: a review of its pharmacology and use as a surgical aid in ophthalmology, and its therapeutic potential in joint disease and wound healing. Drugs 1994; 47 (3): 536–66PubMedCrossRef
2.
Knudson CB, Knudson W. Hyaluronan-binding proteins in development, tissue homeostasis, and disease. FASEB J 1993; 7 (13): 1233–41PubMed
3.
Altman RD. Status of hyaluronan supplementation therapy in osteoarthritis. Curr Rheum Rep 2003; 5 (1): 7–14CrossRef
4.
Hamburger MI, Lakhanpal S, Mooar PA, et al. Intra-articular hyaluronans: a review of product-specific safety profiles. Semin Arthritis Rheum 2003; 32 (5): 296–309PubMedCrossRef
5.
Abatangelo G, O’Regan M. Hyaluronan: biological role and function in articular joints. Eur J Rheum Inflamm 1995; 15 (1): 9–16
6.
Ghosh P, Guidolin D. Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: are the effects molecular weight dependent? Semin Arthritis Rheum 2002; 32 (1): 10–37PubMedCrossRef
7.
Binkley JM, Peat M. The effects of immobilization on the ultrastructure and mechanical properties of the medial collateral ligament of rats. Clin Orthop Relat Res 1986; 203: 301–8PubMed
8.
Säämänen AM, Tammi M, Jurvelin J, et al. Proteoglycan alterations following immobilization and remobilization in the articular cartilage of young canine knee (stifle) joint. J Orthop Res 1990; 8 (6): 863–73PubMedCrossRef
9.
Di Marco C, Letizia GA. Hyaluronic acid in the treatment of pain due to knee joint immobilization: a controlled clinical study. Clin Drug Invest 1995; 10 (4): 191–7CrossRef
10.
Zattoni G, Cabrioli A, Brunelli G, et al. Efficacy and tolerability of hyaluronic acid in acute knee injury: a controlled clinical study. Eur J Rheumatol Inflamm 1995; 15 (1): 63–9
11.
Wang CW, Gao LH, Jin XY, et al. Clinical study of sodium hyaluronate as supplementary treatment for comminution fracture of ankle joints. [in Chinese] Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2002; 16 (1): 21–2PubMed
12.
Dai GF, Tang JW, Wang SJ, et al. Efficacy of intra-articular injection of sodium hyaluronate in post-operation treatment of the knee [in Chinese]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2002; 16 (1): 16–8PubMed
13.
Solchaga LA, Yoo JU, Lundberg M, et al. Hyaluronan-based polymers in the treatment of osteochondral defects. J Orthop Res 2000; 18: 773–80PubMedCrossRef
14.
Marcacci M, Kon E, Zaffagnini S, et al. Autologous chondrocyte transplantation on 3-dimensional hyaluronic acid support (Hyalograft C): histologic evaluation at 1 year follow up. Proceedings of the 70th Annual Meeting of the American Academy of Orthopaedic Surgeons; 2003 Feb 5–9; New Orleans (LA)
15.
Takahashi K, Hashimoto S, Kubo T, et al. Effect of hyaluronan on chondrocyte apoptosis and nitric oxide production in experimentally induced osteoarthritis. J Rheumatol 2000; 27 (7): 1713–20PubMed
16.
Solchaga LA, Goldberg VM, Caplan AI. Experimental models of cartilage repair: cartilage regeneration using principles of tissue engineering. Clin Orthop 2001; 391S: S161–70CrossRef
17.
Espallargues M, Pons JM. Efficacy and safety of viscosupplementation with Hylan G-F 20 for the treatment of knee osteoarthritis: a systematic review. Int J Technol Assess Health Care 2003; 19 (1): 41–56PubMedCrossRef
18.
Kelly MA, Goldberg VM, Healy WL, et al. Osteoarthritis and beyond: a consensus on the past, present and future of hyaluronans in orthopedics. Orthopedics 2003; 26: 1064–79PubMed
19.
Maheu E, Ayral X, Dougados M. A hyaluronan preparation (500–730 kDa) in the treatment of osteoarthritis: a review of clinical trials with Hyalgan. Int J Clin Pract 2002; 56 (10): 804–13PubMed
20.
Yamamoto R, Namiki O, Iwata H, et al. Randomized comparative study of sodium hyaluronate (SPH) on periarthritis scapulohumeralis. Jpn J Clin Pharmacol Ther 1988; 19 (4): 717–33CrossRef
21.
Ueno Y, Kuramoto K, Konno N, et al. Investigation on result of use after launch of ARTZ and ARTZ Dispo: evaluation on the efficacy, safety and utility in the medication for osteoarthritis of the knee and periarthritis of the shoulder. Jpn J Pharmacol Ther 1995; 23 (8): 2151–70
22.
Rovetta G, Monteforte P. Intraarticular injection of sodium hyaluronate plus steroid versus steroid in adhesive capsulitis of the shoulder. Int J Tissue React 1988; 20 (4): 125–30
23.
Ramonda R, Franceschini M, Leardini G. Treatment of shoulder periarthritis with hyaluronic acid. Revista Ital Biol Med 1998; 1 (2 Suppl.): 51S
24.
Leardini G, Perbellini A, Franceschini M, et al. Intra-articular injections of hyaluronic acid in the treatment of painful shoulder. Clin Ther 1988; 10 (5): 521–6PubMed
25.
Itokazu M, Matsunaga T. Clinical evaluation of high-molecular-weight sodium hyaluronate for the treatment of patients with periarthritis of the shoulder. Clin Ther 1995; 17 (5): 946–55PubMedCrossRef
26.
Raynauld J-P, Choquette D, Haraoui B, et al. Hylan vs triamcinolone acetonide injection for acute supraspinatus tendinitis: early report of a randomized controlled trial. Arthritis Rheum 1994; 37 Suppl. 9: 346S
27.
Fernandez-Palazzi F, Viso R, Boadas A, et al. Intra-articular hyaluronic acid in the treatment of haemophilic chronic arthropathy. Haemophilia 2002; 8 (3): 375–81PubMedCrossRef
28.
Bragantini A, Molinaroli F. A pilot clinical evaluation of the treatment of hip osteoarthritis with hyaluronic acid. Curr Ther Res 1994; 55 (3): 319–30CrossRef
29.
Lanzotti SB, Machado MB, Nascimento RA, et al. Intra-articular sodium hyaluronate in unilateral coxofemoral osteoarthritis treatment [abstract]. Arthritis Rheum 2000; 43 Suppl.: S336CrossRef
30.
Brasington R, Reinus W. A pilot study of arthrographically-guided intraarticular injection of hylan for osteoarthritis of the hip. Proceedings of the XIV European League Against Rheumatism Congress; 1999 Jun 6–11; Glasgow, 124
31.
Chevalier X, Conrozier T, Bertin P, et al. Treatment of patients with symptomatic hip OA: a pilot study with intra-articular hylan G-F 20 (Synvisc). Arthritis Rheum 2000; 44 Suppl.: 384S
32.
Brocq O, Tran G, Breuil V, et al. Hip osteoarthritis: short-term efficacy and safety of viscosupplementation by hylan G-F 20: an open-label study in 22 patients. Joint Bone Spine 2002; 69 (4): 388–91PubMedCrossRef
33.
Vad VB, Sakalkale D, Sculco TP, et al. Role of hylan G-F 20 in treatment of osteoarthritis of the hip joint. Arch Phys Med Rehabil 2003; 84: 1224–6PubMedCrossRef
34.
Kopp S, Wenneberg B, Haraldson T, et al. The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction. J Oral Maxillofac Surg 1985; 43 (6): 429–35PubMedCrossRef
35.
Kopp S, Akerman S, Nilner M. Short-term effects of intra-articular sodium hyaluronate, glucocorticoid, and saline injections on rheumatoid arthritis of the temporomandibular joint. J Craniomandib Disord 1991; 5 (4): 231–8PubMed
36.
Bertolami CN, Gay T, Clark GT, et al. Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 1993; 51 (3): 232–42PubMedCrossRef
37.
Hepguler S, Akkoc YS, Pehlivan M, et al. The efficacy of intra-articular sodium hyaluronate in patients with reducing displaced disc of the temporomandibular joint. J Oral Rehabil 2002; 29 (1): 80–6PubMedCrossRef
38.
Shi ZD, Yang F, Zhang JY, et al. Randomized controlled trial of sodium hyaluronate for degenerative disorders of the temporomandibular joint [in Chinese]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2002; 16 (1): 11–5PubMed
39.
Alpaslan GH, Alpaslan C. Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements. J Oral Maxillofac Surg 2001; 59 (6): 613–8PubMedCrossRef
40.
McCain JP, Balazs EA, de la Rua H. Preliminary studies on the use of a viscoelastic solution in arthroscopic surgery of the temporomandibular joint. J Oral Maxillofac Surg 1989; 47 (11): 1161–8PubMedCrossRef
41.
Guarda-Nardini L, Tito R, Staffieri A, et al. Treatment of patients with arthrosis of the temporomandibular joint by infiltration of sodium hyaluronate: a preliminary study. Eur Arch Otorhinolaryngol 2002; 259: 279–84PubMedCrossRef
42.
Mohamed Y, Schumacher HR. Can joints other than knees be safely and successfully treated with intra-articular hyaluronate? Pilot studies on osteo-arthritis of the first MC-C joint. J Rheumatol 2001; 28 (63 Suppl.): 7S
43.
Srejic U, Calvillo O, Kabakibou K. Viscosupplementation: a new concept in the treatment of sacroiliac joint syndrome: a preliminary report of four cases. Reg Anesth Pain Med 1999; 24 (1): 84–8PubMed
44.
Athanassiou-Metaxa M, Koussi A, Economou M, et al. Chemical synoviorthesis with rifampicine and hyaluronic acid in haemophilic children. Haemophilia 2002; 8 (6): 815–6PubMedCrossRef
45.
46.
Migliore A, Martin LS, Alimonti A, et al. Efficacy and safety of viscosupplementation by ultrasound-guided intra-articular injection in osteoarthritis of the hip. Osteoarthritis Cartilage 2003; 11 (4): 305–6PubMedCrossRef
47.
48.
Salk RS, Chang TJ, D’Costa WF, et al. Use of sodium hyaluronate (Hyalgan®) in treating osteoarthritis of the ankle: a randomized, double-blind, placebo-controlled clinical trial [abstract]. Proceedings of the American College of Foot and Ankle Surgeons Annual Scientific Conference; 2004 Feb 11–15, San Diego (CA)
49.
Shi Z, Guo C, Awad M. Hyaluronate for temporomandibular joint disorders (Cochrane Review). Cochrane Database Syst Rev 2003; (1): CD 002970
50.
Goldberg VM, Buckwalter JA. Hyaluronans in the treatment of osteoarthritis of the knee: evidence for disease-modifying activity. Osteoarthritis Cartilage 2005 Mar; 13 (3): 216–24PubMedCrossRef
51.
Frizziero L, Govoni E, Bacchini P. Intra-articular hyaluronic acid in the treatment of osteoarthritis of the knee: clinical and morphological study. Clin Exp Rheumatol 1998; 16 (4): 441–9PubMed
52.
Guidolin DD, Ronchetti IP, Lini E, et al. Morphological analysis of articular cartilage biopsies from a randomized, clinical study comparing the effects of 500–730 kDa sodium hyaluronate (Hyalgan) and methylprednisolone acetate on primary osteoarthritis of the knee. Osteoarthritis Cartilage 2001; 9 (4): 371–81PubMedCrossRef
53.
Listrat V, Ayral X, Patarnello F, et al. Arthroscopic evaluation of potential structure modifying activity of hyaluronan (Hyalgan) in osteoarthritis of the knee. Osteoarthritis Cartilage 1997; 5 (3): 153–60PubMedCrossRef
54.
Pasquali Ronchetti I, Guerra D, Taparelli F, et al. Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis. Rheumatology (Oxford) 2001; 40 (2): 158–69CrossRef
55.
Jubb RW, Piva S, Beinat L, et al. Structure modifying study of hyaluronan (500–730 KDa, Hyalgan) on osteoarthritis of the knee. Arthritis Rheum 2001; 44 Suppl.: 155S
56.
Punzi L, Schiavon F, Ramonda R, et al. Intra-articular hyaluronic acid in the treatment of inflammatory and noninflammatory knee effusions. Curr Ther Res 1988; 43 (4): 643–7
57.
Möller I, Martí N. Chondroprotection: a wider concept? Preliminary clinical experience with hyaluronic acid (Hyalgan) in patients with rheumatoid arthritis. Osteoarthritis and Cartilage 1999; 7 Suppl.: 34
58.
Miura T, Tanba S, Yoshizawa H, et al. High-molecular Na-hyaluronate intra-articular injection for the patients with rheumatoid arthritis combined osteoarthritis of the knee joint [in Japanese]. Igaku to Yakugaku 1993; 29 (4): 1061–71
59.
Goto M, Hanyu T, Yoshio T, et al. Intra-articular injection of hyaluronate (SI-6601D) improves joint pain and synovial fluid prostaglandin E2 levels in rheumatoid arthritis: a multicenter clinical trial. Clin Exp Rheumatol 2001; 19 (4): 377–83PubMed
60.
Tanaka N, Sakahashi H, Sato E, et al. Intra-articular injection of high molecular weight hyaluronan after arthrocentesis as treatment for rheumatoid knees with joint effusion. Rheumatol Int 2002; 22 (4): 151–4PubMedCrossRef
61.
Matsuno H, Yudoh K, Kondo M, et al. Biochemical effect of intra-articular injections of high molecular weight hyaluronate in rheumatoid arthritis patients. Inflamm Res 1999; 48 (3): 154–9PubMedCrossRef
Metadata
Title
Potential Applications of Hyaluronans in Orthopaedics
Degenerative Joint Disease, Surgical Recovery, Trauma and Sports Injuries
Authors
Michael J. Axe
Dr Clarence L. Shields Jr
Publication date
01-10-2005
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 10/2005
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200535100-00003

Other articles of this Issue 10/2005

Sports Medicine 10/2005 Go to the issue

Review Article

Models to Explain Fatigue during Prolonged Endurance Cycling

Review Article

Designing Resistance Training Programmes to Enhance Muscular Fitness

Current Opinion

Erythropoietin Abuse and Erythropoietin Gene Doping

Review Article

Exercise-Associated Hyponatraemia