Intra-articular injections of hyaluronic acid induce positive clinical effects in knees of patients affected by haemophilic arthropathy
ABSTRACT INTRODUCTION: Haemophilic arthropathy is the most common clinical manifestation of haemophilia, secondary to recurrent haemarthrosis and chronic synovitis, and the knee represents the main target joint. Modern bleeding prevention has significatively limited the incidence of severe arthropathy, and primary approach is usually conservative. Viscosupplementation is felt as one of the most efficient treatments for the early stages of knee haemophilic arthropathy, based on short-term follow-up studies. The aim of this prospective case series study is to assess the clinical effectiveness of intra-articular administration of hyaluronic acid in the knee, evaluating long-term results, and focusing on the necessity of further treatments after viscosupplementation. METHODS: Twenty-seven haemophilic patients with knee arthropathy underwent at least two cycles of injections of hyaluronians between 2003 and 2009. They were evaluated with VAS, SF-36, WFH, Pettersson score, and WOMAC, with a seven-year follow-up. RESULTS: All patients showed improvement in pain relief and functional recovery without any complications. Considering the severity of arthropathy in haemophilic patients, only a limited number of subjects (five) underwent total knee arthroplasty for persistent pain or functional limitation. CONCLUSIONS: Viscosupplementation is a safe and effective therapeutic strategy in knee haemophilic arthropathy, with no complications, persisting good clinical results, and determining in most cases a delay of surgery.
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ABSTRACT: Objetivo avaliar a eficácia do uso do ácido hialurônico no pós‐operatório de artroscopia de joelho. Métodos foram avaliados 49 pacientes submetidos ao procedimento artroscópico associado ao uso do ácido hialurônico intra‐articular (Grupo I) e 49 pacientes submetidos ao procedimento artroscópico sem uso do ácido hialurônico (Grupo II). Os pacientes foram avaliados com base na Escala Visual Analógica de dor (EVA), analgesia domiciliar, amplitude do movimento do joelho com goniômetro e no questionário Lysholm. Resultados não ocorreram efeitos adversos significativos em nenhum dos dois grupos. Conclusão o uso do ácido hialurônico no pós‐operatório de artroscopia de joelho é justificado por levar a uma diminuição da dor na fase inicial e possibilitar uma recuperação mais rápida do paciente.02/2014; 49(1):37–43. DOI:10.1016/j.rboe.2014.01.005
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ABSTRACT: Objective Evaluate the efficacy of hyaluronic acid in the post-operative of knee arthroscopy. Methods We have evaluated 49 patients undergoing arthroscopic procedure with the use of intra-articular hyaluronic acid (group I) and 49 patients undergoing arthroscopic procedure without the use of hyaluronic acid (group II). Patients were evaluated based on the Visual Analogue Scale, household analgesia, assessment of the Range of Motion with a goniometer, and the Lysholm questionnaire. Results There were no substantial adverse effects on either group. Conclusion The use of hyaluronic acid in the post-operative of knee arthroscopy is justified due/because it leads to a decrease in pain in the early stage, enabling faster recovery of the patient.Revista Brasileira de Ortopedia 02/2014; 49(1):37–43. DOI:10.1016/j.rbo.2012.12.002
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ABSTRACT: A novel soft way of hyaluronate (HyA) based magnetic hydrogel preparation was revealed. Magnetite nanoparticles (MNPs) were prepared by co-precipitation. Since the naked MNPs cannot be dispersed homogenously in HyA-gel, their surface was modified with natural and biocompatible chondroitin-sulfate-A (CSA) to obtain CSA-coated MNPs (CSA@MNPs). The aggregation state of MNPs and that loaded with increasing amount of CSA up to 1 mmol/g was measured by dynamic light scattering at pH~6. Only CSA@MNP with ≥0.2 mmol/g CSA content was suitable for magnetic HyA-gel preparation. Rheological studies showed that the presence of CSA@MNP with up to 2 g/L did not affect the hydrogel's rheological behavior significantly. The results suggest that the HyA-based magnetic hydrogels may be promising formulations for future biomedical applications, e.g. as intra-articular injections in the treatment of osteoarthritis.Journal of Magnetism and Magnetic Materials 10/2014; 380. DOI:10.1016/j.jmmm.2014.10.139 · 2.00 Impact Factor