Viscosupplementation with hyaluronic acid in the treatment for cartilage lesions: a review of current evidence and future directions

General Review

Abstract

Diseases involving the articular cartilage are one of the leading causes of physical impairment among the adult population. While surgical technique and advancement have allowed us effective means at treating these diseases, this is not without significant risk and morbidity. With a very solid safety profile, viscosupplementation with hyaluronic acid (HA) derivatives has become an excellent modality for treating diseased articular cartilage. Recent literature supports the use of HA not only in the management of the pain associated with osteoarthritis but also as a disease-modifying agent as well. Further studies have started to define exciting new roles for viscosupplementation in the treatment for acute injuries to the joint microenvironment.

Keywords

Viscosupplementation Hyaluronic acid Treatment of cartilage lesions 

Notes

Conflict of interest

The authors declare that they have no conflict of interests.

References

  1. 1.
    Ayral X (2001) Injections in the treatment of osteoarthritis. Best Prac Res Clin Rheumatol 15:609–626CrossRefGoogle Scholar
  2. 2.
    Tehranzadeh J, Booya F, Root J (2005) Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review. Acta Radiol 3:288–296CrossRefGoogle Scholar
  3. 3.
    Lo G, Michael L, McAlindon T (2003) Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis. JAMA 290(23):3115–3121PubMedCrossRefGoogle Scholar
  4. 4.
    Watterson JR, Esdaile JM (2000) Viscosupplementation: therapeutic mechanisms and clinical potential in osteoarthritis of the knee. J Am Acad Orthop Surg. 8(5):277–284PubMedGoogle Scholar
  5. 5.
    Moreland LW (2003) Intra-articular hyaluronan (hyaluronic acid) and hylans for the treatment of osteoarthritis: mechanisms of action. Arthritis Res Ther 5(2):54–67PubMedCrossRefGoogle Scholar
  6. 6.
    Buckwalter JA, Saltzman C, Brown T (2004) The impact of osteoarthritis: implications for research. Clin Orthop Relat Res 427(suppl):S6–S15PubMedCrossRefGoogle Scholar
  7. 7.
    (2007) Physicians desk reference, 61st edn. Thomson PDR, MontvaleGoogle Scholar
  8. 8.
    Goldberg VM, Buckwalter JA (2005) Hyaluronans in the treatment of osteoarthritis of the knee: evidence for disease-modifying activity. Osteoarth Cartil 13(3):216–224CrossRefGoogle Scholar
  9. 9.
    Chevalier X, Jerosch J, Goupille P, van Dijk N, Luyten FP, Scott DL, Bailleul F, Pavelka K (2010) Single, intra-articular treatment with 6 ml hylan G-F 20 in patients with symptomatic primary osteoarthritis of the knee: a randomised, multicentre, double-blind, placebo controlled trial. Ann Rheum Dis 69(1):113–119PubMedCrossRefGoogle Scholar
  10. 10.
    Conrozier T, Jerosch J, Beks P, Kemper F, Euller-Ziegler L, Bailleul F, Chevalier X (2009) 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. Arch Orthop Trauma Surg 129(3):417–423PubMedCrossRefGoogle Scholar
  11. 11.
    Puhl W, Bernau A, Greiling H et al (1993) Intra-articular sodium hyaluronate in osteoarthritis of the knee: a multicenter, double-blind study. Osteoarthr Cartil 1(4):233–241PubMedCrossRefGoogle Scholar
  12. 12.
    Bellamy N, Campbell J, Robinson V et al. (2006) Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev CD005321Google Scholar
  13. 13.
    Richmond J, Hunter D, Irrgang J et al (2009) American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad Orthop Surg 17(9):591–600PubMedGoogle Scholar
  14. 14.
    Wang CT, Lin J, Chang CJ, Lin YT, Hou SM (2004) Therapeutic effects of hyaluroinc acid on osteoarthritis of the knee: a meta-analysis of randomized controlled trials. J Bone Joint Surg Am 86-A:538–545PubMedGoogle Scholar
  15. 15.
    Altman RD, Moskowitz R (1999) Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group. J Rheumatol 26(5):1216Google Scholar
  16. 16.
    Sen C, Gunes T, Saygi B et al (2008) The chondroprotective effect of intra-articular hyaluronic acid at early stages of osteoarthritis: an experimental study in rabbits. Acta Orthop Traumatol Turc 38(5):348–352Google Scholar
  17. 17.
    Conrozier T, Bertin P, Mathieu P, Charlot J, Bailleul F, Treves R, Vignon E, Chevalier X (2003) Intra-articular injections of hylan G-F 20 in patients with symptomatic hip osteoarthritis: an open-label, multicentre, pilot study. Clin Exp Rheumatol 21(5):605–610PubMedGoogle Scholar
  18. 18.
    Sun SF, Chou YJ, Hsu CW, Chen WL (2009) Hyaluronic acid as a treatment for ankle osteoarthritis. Curr Rev Musculoskelet Med 2(2):78–82PubMedCrossRefGoogle Scholar
  19. 19.
    Blaine T, Moskowitz R, Udell J, Skyhar M, Levin R, Friedlander J, Daley M, Altman R (2008) Treatment of persistent shoulder pain with sodium hyaluronate: a randomized, controlled trial. A multicenter study. J Bone Joint Surg Am 90(5):970–979PubMedCrossRefGoogle Scholar
  20. 20.
    Kaplan LD, Lu Y, Snitzer J, Nemke B, Hao Z, Biro S, Albiero W, Stampfli HF, Markel M, Popkin C, Baum SZ (2009) The effect of early hyaluronic acid delivery on the development of an acute articular cartilage lesion in a sheep model. Am J Sports Med 37(12):2323–2327PubMedCrossRefGoogle Scholar
  21. 21.
    Sonoda M, Harwood FL, Amiel ME, Moriya H, Temple M, Chang DG, Lottman LM, Sah RL, Amiel D (2000) The effects of hyaluronan on tissue healing after meniscus injury and repair in a rabbit model. Am J Sports Med 28(1):90–97PubMedGoogle Scholar
  22. 22.
    Hempfling H (2007) Intra-articular hyaluronic acid after knee arthroscopy: a two-year study. Knee Surg Sports Traumatol Arthrosc 15(5):537–546PubMedCrossRefGoogle Scholar
  23. 23.
    Huang MH, Yang RC, Chou PH (2007) Preliminary effects of hyaluronic acid on early rehabilitation of patients with isolated anterior cruciate ligament reconstruction. Clin J Sport Med 17(4):242–250PubMedCrossRefGoogle Scholar
  24. 24.
    Yagishita K, Sekiya I, Sakaguchi Y et al (2005) The effect of hyaluronan on tendon healing in rabbits. Arthroscopy 21(11):1330–1336PubMedCrossRefGoogle Scholar
  25. 25.
    Shikhman AR, Kuhn K, Alaaeddine N, Lutz M (2001) N-acetylglucosamine prevents IL1 mediated activation of human chondrocytes. J Immunol 166:5155–5160PubMedGoogle Scholar
  26. 26.
    Shikhman AR, Amiel D, Lima DD, Hwung SB, Hu C, Xu A, Hashimoto S, Kobayashi K, Sasho T, Lotz MK (2005) Chondroprotective activity of N-Acetylglucosamine in rabbits with experimental osteoarthritis. Ann Rheum Dis 64:89–94PubMedCrossRefGoogle Scholar
  27. 27.
    Campo GM, Avenoso A, Campo S, Ferlazzo AM, Altavilla D, Calatroni A (2003) Efficacy of treatment with glucosaminoglycans on experimental collagen induced arthritis in rats. Arthritis Res Ther 5:R122–R131PubMedCrossRefGoogle Scholar
  28. 28.
    Sabaratnam S, Coleman PJ, Badrick E, Mason RM, Levick JR (2002) Interactive effect of chondroitin sulphate C and hyaluronan on fluid movement across rabbit synovium. J Physiol 540(1):271–284PubMedCrossRefGoogle Scholar
  29. 29.
    Frisbie DD, Kawcak CE, Mcllwraith CW, Werpy NM (2009) Evaluation of polysulfated glucosaminoglycans or sodium hyaluronan administered intraarticularly for treatment of horses with experimentally induced osteoarthritis. Am J Vet Res 70:203–209PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Travis E. Clegg
    • 1
  • David Caborn
    • 1
  • Cyril Mauffrey
    • 1
    • 2
  1. 1.Department of Orthopaedic SurgeryUniversity of LouisvilleLouisvilleUSA
  2. 2.Orthopedic Traumatology, Denver Health Medical CentreDenverUSA

Personalised recommendations