Hyaluronic acid for joints

Most recently, medicine began to use drugs, which include hyaluronic acid - a mucopolysaccharide, which is present in all healthy tissues of the human body. Especially popular is hyaluronic acid for joints: the introduction of this substance into the joint cavities is often called "liquid prosthetics," as it acquires in the joint the properties of natural synovial fluid - a natural lubricant. What is hyaluronate, and how is it used in orthopedics?

[1], [2], [3]

Indications for the use of hyaluronic acid for joints

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

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

Most often in medical practice, this 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 the appointment of therapy are signs of arthrosis of the hip joint.

Hyaluronic acid is introduced at any stage of alteration or destruction of the cartilaginous tissue. But, undoubtedly, the most effective is the timely administration of therapy at the initial stages of the disease, when the restorative properties of the tissues are not yet violated.

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

Form of issue

The main means of therapy of joint diseases with the use of hyaluronate is injections. The course of such treatment has a rather high cost, but its effectiveness can not be compared with any other similar treatment: puffiness quickly disappears, soreness disappears, mobility returns to the joint. In addition, the treatment has virtually no contraindications and can be used at any age.

Nevertheless, just a few years ago the pharmaceutical market offered new hyaluronic acid preparations for joints in the form of tablets and external creamy products, which are positioned as a "new view of medicine." Companies that sell these medicines advertise them as a means to preserve youth and joint mobility. This move is designed to take a pill or apply an ointment much easier and cheaper than taking an injection treatment course. However, scientists did not conduct practical studies on the benefits and harmlessness of these drugs. Moreover, most of the proposed remedies were not medicines at all, but so-called biologically active additives.

Therefore, experts unequivocally do not recommend using any other form of hyaluronic acid for treatment, except for injections. If you still acquired a "miraculous" remedy, then before using it, consult a doctor.

[4]

Pharmacodynamics

When the drugs of hyaluronic acid get inside the joint bag, several useful therapeutic actions are found simultaneously:

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

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

Hyaluronic treatment is a kind of alternative to a surgical operation. The third way to restore the affected cartilage tissue in medicine yet, so this therapeutic course is simply indispensable in the symptoms of secondary arthrosis.

Pharmacokinetics

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

The pharmacokinetic properties of hyaluronate injections are not yet fully understood.

Dosing and Administration

The standard treatment scheme involves the introduction of hyaluronic acid into the cavity of the damaged joint. Injections are performed once in 7 days, on the course - from 3 to 5 injections.

Simultaneous introduction of the drug into several joint capsules is allowed.

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

How is the injection done:

• the doctor breaks the package with a filled syringe;
• removes the syringe;
• removes the cap and puts on the necessary cannula size;
• fixes the cannula with a slight turn;
• releases an air bubble from the syringe and injects the needle into the joint cavity.

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

In the presence of an inflammatory process inside the joint before the injection, first prescribe a corticosteroid drug treatment. This will relieve inflammation and increase the effectiveness of treatment with hyaluronic acid.

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

• injection into the joint is performed only under ideally sterile conditions;
• if after the first five injections there is no improvement, the course should be discontinued and more effective types of treatment should be sought;
• if a decrease in the level of the intra-articular fluid is detected against the background of treatment, a need arises for joint puncture;
• when injecting the drug should beware of damage to the blood vessels;
• avoid getting the drug into the eye area.

[7], [8], [9], [10], [11]

Use during pregnancy

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

Contraindications for use

Like any medication, funds based on hyaluronic acid have certain contraindications to the use of:

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

[5], [6]

Side effects of hyaluronic acid for joints

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

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

• a feeling of warming at the injection site;
• burning;
• itching;
• rapid pain in the muscles;
• swelling;
• redness of the skin.

To eliminate these symptoms, it is often sufficient to apply a cold compress to the affected joint, or an ice bag. As a rule, the side effects disappear without consequences for ten minutes.

If, after the administration of the drug, the symptoms of allergy are found, then immediately consult a doctor, as this increases the risk of anaphylactic reaction.

Overdose

Cases of overdose with hyaluronic acid preparations have not been described.

Interactions with other drugs

It is necessary to avoid the combination of hyaluronic acid and disinfectants such as ammonium salts, as well as benzalkonium chloride and chlorhexidine, as this contributes to the appearance of a precipitate.

Storage conditions

In most cases, preparations based on hyaluronic acid are stored in darkened places with temperatures from +1 to + 25 ° C. More precise storage conditions should be read on the package for the specific preparation. Children should not be allowed to play near the storage of medicinal products.

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

The most popular preparations of hyaluronic acid for joints

• Adant - comes in the form of a viscoelastic fluid placed in a syringe. Contains 25 mg of hyaluronate. Produced in Japan.
• The syncope is available in glass sterile syringes in three possible dosages (standard, mini and forte). Produced in Austria.
• Ostenil - is released as a 1% solution in sterile syringes for 10, 20 or 40 mg. Produced in Switzerland.
• Fermatron - is released in a sterile glass syringe in the amount of 2 mg of the active component of hyaluronate in 20 mg of the solution. Is a non-proprietary drug.
• Hyastat - is available in the form of a hydrogel, which is contained in a sterile syringe in an amount of 20 mg. Produced in Russia.

The modern pharmacological industry has a large number of preparations based on the active component of hyaluronate. Such medicines are presented by both foreign and domestic manufacturers. The choice of a particular tool, of course, is yours. Just remember that the quality of the medication 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

To date, the cost of hyaluronic acid in injections for intra-articular injection is quite significant, so not everyone can afford this treatment. As a rule, the price for one ampule can be from 1200 UAH and above, depending on the manufacturer and the price policy of a specific pharmacy network.

In addition, most likely, you will have to pay for the procedure itself. For example, in paid clinics, intra-articular injection under the supervision of ultrasound may cost about 200 UAH per shot.

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