AN OVERVIEW OF VISCOSUPPLEMENTS: THERAPEUTIC MODALITY FOR THE AILMENT OF OSTEOARTHRITIS

Authors

  • Devesh Kapoor Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601
  • Chaitali Lad Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601
  • Ruchi Vyas Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601
  • Manish Patel Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601

Abstract

Osteoarthritis is a multifarious joint disease and is caused by inflammatory mediators, along with a procedure of wear and tear of cartilage. Osteoarthritis outcome in cartilage degradation, synovial inflammation, subchondral bone eburnation, degeneration of menisci, and capsular hypertrophy, which takes part in the pathogenesis of Osteoarthritis. Pain is the leading symptom of Osteoarthritis. However the precise mechanism causing pain is multifactorial and is still not well known. Viscosupplementation with intraarticular hylauronic acid promotes chondrocyte hyaluronic acid synthesis and prevents the additional cartilage degradation and may possible help to promote the cartilage regeneration. It is also postulated to diminish the production of inflammatory mediators and matrix metalloproteinase involved in Osteoarthritis. Viscosupplementation decline osteoarthritis symptoms in early to judicious Osteoarthritis, and improves functional outcome, if other conservative treatment modalities are ineffective. Hyaluronic acid (HA) is the major constituent of a 1-­â€2μm layer on the surface of articular cartilage; it is also a major constituent of synovial fluid. HA has many properties including exerting an anti-inflammatory effect, it acts as a lubricant when movements in the joint are slow and as a shock absorber when movements are fast effect. Viscosupplementation relieves the symptoms of osteoarthritis of the knee, and this therapeutic effect may last several weeks. However, it is apparently not much greater than that of placebo and, according to some studies, it barely reaches clinical significance. Its pain-relieving effect seems comparable to that of other non-surgical options. The modest clinical benefit of viscosupplementation may never be great enough to outweigh its disadvantages, which include slow onset of action, the need for several weekly injections, the low but present risk of adverse reactions and the relatively high cost of this treatment. It helps in improving the function in early osteoarthritis knee joint and might delay the need for future knee surgery

Keywords: Joint disorders, intraarticular hylauronic acid, non-steroidal anti-inflammatory drugs, osteoarthritis

 

DOI

https://doi.org/10.22270/jddt.v6i4.1214

Author Biographies

Devesh Kapoor, Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601

Dayaram Patel Pharmacy CollegeSardar baug, Station Road, BardoliDist – Surat, Gujarat, India, Pin-394601

Chaitali Lad, Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601

Dayaram Patel Pharmacy College

Sardar baug, Station Road, Bardoli

Dist – Surat, Gujarat, India, Pin-394601

Ruchi Vyas, Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601

Dayaram Patel Pharmacy College

Sardar baug, Station Road, Bardoli

Dist – Surat, Gujarat, India, Pin-394601

Manish Patel, Dayaram Patel Pharmacy College Sardar baug, Station Road, Bardoli Dist – Surat, Gujarat, India, Pin-394601

Dayaram Patel Pharmacy College

Sardar baug, Station Road, Bardoli

Dist – Surat, Gujarat, India, Pin-394601

References

Creamer P, Hochberg Mc. Osteoarthritis. Lancet 1997; 350: 503-508.

Yelin Eh, Felts Wr. A summary of the impact of musculoskeletal conditions in the United States. Arthritis Rheum 1990; 33: 750-755.

Cunningham Ls, Kelsey Jl. Epidemiology of musculoskeletal impairments and associated disability. Am J Public Health 1984; 74: 57-49.

Guccione Aa, Felson Dt, Anderson Jj, Anthony Jm, Zhang Y, Wilson Pw, Kelly-Hayes M, Wolf Pa, Kreger Be, Kannel Wb. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994; 84: 351-358.

Lawrence Rc, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, Heyse SP, Hirsch R, Hochberg MC, Hunder Gg, Liang Mh, Pillemer Sr, Steen Vd, Wolfe F. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998; 41: 778-799.

Gabriel Se, Crowson Cs, Campion Me, O’fallon Wm. Indirect and nonmedical costs among people with rheumatoid arthritis and osteoarthritis compared with nonarthritic controls. J Rheumatol 1997 24: 43-48.

Gabriel Se, Crowson Cs, Campion Me, O’fallon Wm. Direct medical costs unique to people with arthritis. J Rheumatol 1997; 24: 719-725.

Brandt KD,Smith GN Jr., Lee S. Intrarticular injection of hyaluronan of as treatment for knee osteoarthritis: What is the evidence? Arthritis and Rheumatism. 2000; 43(6):1192-­1203.

Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 2010; 18: 476-499 [ DOI: 10.1016/ j.joca.2010.01.013]

Kon E, Filardo G, Drobnic M, Madry H, Jelic M, van Dijk N, Della Villa S. Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2012; 20: 436-449 [DOI: 10.1007/s00167-011-1713-8]

Maneiro E, de Andres MC, Fernández-Sueiro JL, Galdo F,Blanco FJ, et al. The biological action of hyaluronan on human osteoartritic articular chondrocytes: the importance of molecular weight. Clin Exp Rheumatol 2004; 22: 307-312.

Brockmeier SF, Shaffer BS. Viscosupplementation therapy for osteoarthritis. Sports Med Arthrosc 2006; 14: 155-162.

Goa KL, Benfield P. Hyaluronic acid,et al. 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: 536-566.

Axe JM, Snyder-Mackler L, Axe MJ, et al. The role of viscosupplementation. Sports Med Arthrosc 2013; 21: 18-22.

Zychowicz, ME. Viscosupplementation for knee osteoarthritis. American Association of Nurse Practitioners 2014, 26: 163–175.

Conrozier T, Vignon E. Is there evidence to support the inclusion of viscosupplementation in the treatment paradigm for patients with hip osteoarthritis? Clin Exp Rheumatol. 2005; 23(5):711-716.

Migliore A, Tormenta S, Martin Martin LS, et al. The symptomatic effects of intra-articular administration of hylan G-F 20 on osteoarthritis of the hip: Clinical data of 6 months follow-up. Clin Rheumatol. 2006;25(3):389-393.

Van den Bekerom MP, Lamme B, Sermon A, Mulier M. What is the evidence for viscosupplementation in the treatment of patients with hip osteoarthritis? Systematic review of the literature. Arch Orthop Trauma Surg. 2008; 128(8):815-823.

Carpenter B, Motley T. The role of viscosupplementation in the ankle using hylan G-F J Foot Ankle Surg. 2008; 47(5):377-384.

Cleary M, Keating C, Poynton AR. Viscosupplementation in lumbar facet joint arthropathy: A pilot study. J Spinal Disord Tech. 2008; 21(1):29-32.

Conrozier T, Couris CM, Mathieu P, et al. Safety, efficacy and predictive factors of efficacy of a single intra-articular injection of non-animal-stabilized-hyaluronic-acid in the hip joint: Results of a standardized follow-up of patients treated for hip osteoarthritis in daily practice. Arch Orthop Trauma Surg. 2009; 129(6):843-848.

Vanelli R, Costa P, Rossi SM, Benazzo F. Efficacy of intra-articular polynucleotides in the treatment of knee osteoarthritis: A randomized, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc. 2010; 18(7):901-907.

Manfredini D, Piccotti F, Guarda-Nardini L. Hyaluronic acid in the treatment of TMJ disorders: A systematic review of the literature. Cranio. 2010; 28(3):166-176.

Published

15-07-2016
Statistics
Abstract Display: 603
PDF Downloads: 770

How to Cite

1.
Kapoor D, Lad C, Vyas R, Patel M. AN OVERVIEW OF VISCOSUPPLEMENTS: THERAPEUTIC MODALITY FOR THE AILMENT OF OSTEOARTHRITIS. J. Drug Delivery Ther. [Internet]. 2016 Jul. 15 [cited 2025 Apr. 20];6(4):73-8. Available from: https://www.jddtonline.info/index.php/jddt/article/view/1214

How to Cite

1.
Kapoor D, Lad C, Vyas R, Patel M. AN OVERVIEW OF VISCOSUPPLEMENTS: THERAPEUTIC MODALITY FOR THE AILMENT OF OSTEOARTHRITIS. J. Drug Delivery Ther. [Internet]. 2016 Jul. 15 [cited 2025 Apr. 20];6(4):73-8. Available from: https://www.jddtonline.info/index.php/jddt/article/view/1214

Most read articles by the same author(s)