Hyaluronic acid for joints

Quite recently, medicine has begun to use drugs that contain hyaluronic acid - a mucopolysaccharide that is present in all healthy tissues of the human body. Hyaluronic acid is especially popular for joints: the introduction of this substance into joint cavities is often called "liquid prosthetics", since it acquires the properties of natural synovial fluid in the joint - a natural lubricant. What is hyaluronate, and how is it used in orthopedics?

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Indications for the use of hyaluronic acid for joints

Hyaluronate can be found inside the epithelium, in nerve and connective tissue fibers. It is well known that this substance is part of the synovial fluid, responsible for the absence of friction of the joint elements and improving cushioning. Hyaluronate works as a lubricant, providing smoothness of movements and preventing premature tissue production. With a lack or incorrect composition of synovial fluid, joint structure disorders may occur, which, first of all, will cause pain and a decrease in the amplitude of movements.

The process of changing the composition and quantity of "lubricant" can be caused by hereditary predisposition, excessive physical overload, excess weight, age, etc. If a peculiar "drying of the joint" is observed, then the doctor may well recommend treatment with hyaluronic acid to the patient.

Most often in medical practice, such treatment is used for arthrosis. For example, hyaluronic acid for the knee joint is used regardless of the cause of the pathology.

The next indication for prescribing therapy is signs of hip joint arthrosis.

Hyaluronic acid is administered at any stage of change or destruction of cartilage tissue. But, of course, the most effective is considered to be timely therapy at the initial stages of the disease, when the restorative properties of the tissues are not yet impaired.

Hyaluronic injections are also prescribed during the rehabilitation period after joint injuries, or after an arthroscopy procedure.

Release form

The main means of treating joint diseases using hyaluronate is injections. A course of such treatment is quite expensive, but its effectiveness cannot be compared with any other similar treatment: swelling quickly goes away, pain disappears, and mobility returns to the joint. In addition, the treatment has virtually no contraindications and can be used at any age.

However, just a few years ago, the pharmaceutical market offered new hyaluronic acid preparations for joints in the form of tablets and external creams, which are positioned as a "new look at medicine." Companies that sell these medications advertise them as a means of preserving youth and joint mobility. This move is based on the fact that taking a pill or applying an ointment is much easier and cheaper than undergoing a course of treatment with injections. However, scientists have not conducted practical studies on the benefits and harmlessness of these drugs. Moreover, most of the proposed products were not drugs at all, but so-called biologically active additives.

Therefore, experts definitely do not recommend using any other forms of hyaluronic acid for treatment, except injections. If you nevertheless purchased the "miracle" remedy, then consult a doctor before using it.

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Pharmacodynamics

When hyaluronic acid preparations enter the joint capsule, several beneficial therapeutic effects are simultaneously observed:

• the viscosity of the intra-articular lubricant increases, and the mutual friction of the joint surfaces during motor activity decreases;
• the trophism of cartilaginous tissues improves, favorable conditions are created for the processes of joint regeneration (or more precisely, its cartilage);
• the development of intra-articular inflammatory reactions is prevented.

The effectiveness of treatment of the initial stages of dystrophic changes in the joint is especially noticeable. An important point is that if there is an inflammatory process in the joint capsule, injections will not be successful. Hyaluronate loses its properties if the patient suffers not only from arthrosis, but also from arthritis. Therefore, if there is an inflammatory process, anti-inflammatory therapy should be carried out first, and only then proceed to hyaluronic acid injections.

Hyaluronic treatment is a kind of alternative to surgery. There is no third method of restoring damaged cartilage tissue in medicine yet, so such a therapeutic course is simply irreplaceable for symptoms of secondary arthrosis.

Pharmacokinetics

Hyaluronic acid is a natural polymer substance that determines the viscosity and elasticity of the joint lubricant. Typically, this substance accumulates on top of the joint membrane and cartilage, absorbing vibrations and shocks, and also providing exchange processes between the joint fluid itself and the cartilage surface.

The pharmacokinetic properties of hyaluronate injections have not yet been thoroughly studied.

Method of administration and dosage

The standard treatment regimen involves the introduction of hyaluronic acid into the cavity of the damaged joint. Injections are given once every 7 days, with a course of 3 to 5 injections.

Simultaneous administration of the drug into several joint capsules is permitted.

If the doctor deems it necessary, he may prescribe an additional course of treatment.

How the injection is performed:

• the doctor tears open the package with a filled syringe;
• takes out the syringe;
• removes the cap and puts on a cannula of the required size;
• secures the cannula with a slight twist;
• releases the air bubble from the syringe and inserts the needle into the joint cavity.

It is recommended to repeat the injection courses every 6-12 months.

If there is an inflammatory process inside the joint, before administering injections, treatment with corticosteroids is first prescribed. This will relieve inflammation and increase the effectiveness of treatment with hyaluronic acid.

There are also generally accepted rules for intra-articular administration of drugs:

• injection into the joint is carried out only under perfectly sterile conditions;
• If there is no improvement after the first five injections, the course should be interrupted and more effective types of treatment should be sought;
• If, during treatment, a decrease in the level of intra-articular fluid is detected, then a joint puncture becomes necessary;
• When administering the drug, care should be taken to avoid damaging blood vessels;
• Avoid getting the drug in the eye area.

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Use during pregnancy

Preparations based on hyaluronic acid are prohibited for use during pregnancy and breastfeeding due to insufficient study of their pharmacokinetic properties.

Contraindications for use

Like any medical drug, hyaluronic acid-based products have certain contraindications for use:

• hypersensitivity reactions to the main or additional components of the product;
• wound surfaces or dermatological pathologies in the area where the injection will be performed;
• the presence of an inflammatory reaction inside the joint;
• childhood;
• period of pregnancy and breastfeeding;
• acute period of infectious diseases, febrile conditions.

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Side effects of hyaluronic acid for joints

Hyaluronate is usually well tolerated by patients. The drug does not cause any intoxication or significant effects on the body.

Side effects are extremely rare. These may be local secondary manifestations:

• a feeling of warmth at the injection site;
• burning;
• itching;
• transient muscle pain;
• swelling;
• redness of the skin.

To eliminate the listed symptoms, it is often enough to apply a cold compress or a bag of ice to the affected joint. As a rule, the side effects disappear without consequences within ten minutes.

If, after the administration of the drug, allergy symptoms are detected, you should immediately consult a doctor, as this increases the risk of developing an anaphylactic reaction.

Overdose

There have been no reports of overdose with hyaluronic acid preparations.

Interactions with other drugs

The combination of hyaluronic acid and disinfectants such as ammonium salts, benzalkonium chloride and chlorhexidine should be avoided, as this promotes the formation of sediment.

Storage conditions

In most cases, hyaluronic acid-based products are stored in dark places with a temperature of +1 to +25°C. More precise storage conditions should be read on the packaging of a specific product. Children should not be allowed to play near places where medicines are stored.

The shelf life of hyaluronic acid for joints can be three years.

The most popular hyaluronic acid preparations for joints

• Adant – is produced as a viscoelastic liquid placed in a syringe. Contains 25 mg of hyaluronate. Manufactured in Japan.
• Sinocrom is available in sterile glass syringes in three possible dosages (standard, mini and forte). Manufactured in Austria.
• Ostenil is available as a 1% solution in sterile syringes of 10, 20 or 40 mg. Manufactured in Switzerland.
• Fermatron is available in a sterile glass syringe in the amount of 2 mg of the active component hyaluronate in 20 mg of solution. It is a non-proprietary drug.
• Giastat is produced in the form of a hydrogel, which is contained in a sterile syringe in the amount of 20 mg. Manufactured in Russia.

The modern pharmaceutical industry has a large number of drugs based on the active component hyaluronate. Such drugs are presented by both foreign and domestic manufacturers. The choice of a specific drug is, of course, yours. Just remember that the quality of the drug sometimes depends not only on the effectiveness of treatment, but also on the further state of your health in general.

Price of hyaluronic acid for joints

Today, the cost of hyaluronic acid in injections for intra-articular administration is quite significant, so not everyone can afford such treatment. As a rule, the price for one ampoule can be from 1200 UAH and higher, depending on the manufacturer and the pricing policy of a particular pharmacy chain.

In addition, you will most likely have to pay for the procedure itself. For example, in private clinics, an intra-articular injection under ultrasound control can cost about 200 UAH per injection.

However, even despite the considerable price, hyaluronic acid for joints is considered a very effective treatment: after several courses of procedures, complete restoration of the affected joint is possible.