Viscosupplementation for the treatment of osteoarthritis of the knee
 
More details
Hide details
1
Katedra Biochemii Wydziału Lekarskiego z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląskiego Uniwersytetu Medycznego w Katowicach
 
2
Szpital Miejski w Rudzie Śląskiej
 
3
Samodzielny Publiczny Wojewódzki Szpital Chirurgii Urazowej im. dr. Janusza Daaba w Piekarach Śląskich
 
4
Powiatowy Zespół ZOZ w Będzinie
 
 
Corresponding author
Alina Beata Ostałowska   

Alina Ostałowska, Katedra Biochemii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, ul. Jordana 19, 41-808 Zabrze
 
 
Ann. Acad. Med. Siles. 2017;71:38-45
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Osteoarthritis of the knee (gonarthritis – GA) is one of the most common musculoskeletal disorders. Pain and limitation of joint movement are the most constant and troublesome symptoms of the joint pathology. The aim of the study was to examine viscosupplementation therapy with hyaluronic acid.

Material and methods:
96 patients were administered hyaluronic acid unilaterally (the 1K group), while 33 patients were administered hyaluronic acid bilaterally (the 2K group) in a 40-day cycle. The stage of the disease was assessed based on medical history, physical examination and a questionnaire survey. Analysis of the following parameters was performed: serum level of sulfhydryl groups (SH), total oxidant status (TOS), catalase activities (CAT) and glutathione peroxidase (GPx) in erythrocytes and superoxide dismutase activity (SOD) in plasma and erythrocytes.

Results:
Viscosupplementation resulted in pain reduction and improvement in the HHS score. The SOD and CAT activities were significantly decreased, while GPx activity as well as the SH level significantly increased in both the examined groups. In addition the TOS values significantly decreased.

Conclusions:
Viscosupplementation therapy with hyaluronic acid significantly reduces pain of the knee joint, improves its function and has a beneficial effect on the pro/antioxidant balance in the blood of patients diagnosed with GA. The effects of uni- and bilateral administration of hyaluronic acid are similar.

REFERENCES (30)
1.
O'Connor M.I. Sex differences in osteoarthritis of the hip and knee. J Am Acad Orthop Surg. 2007; 15(Suppl. 1): 22–25.
 
2.
Ghosh P., Cheras P.A. Vascular mechanisms in osteoarthritis. Best Pract. Res. Clin. Rheumatol. 2001; 15(5): 693–703.
 
3.
DeLeo J.A., Yezierski R.P. The role of neuroinflammation and neuroimmune activation in persistent pain. Pain 2001; 90(1–2): 1–6.
 
4.
Silver F.H., Bradica G., Tria A. Relationship among biomechanical, biochemical, and cellular changes associated with osteoarthritis. Crit. Rev. Biomed. Eng. 2001; 29(4): 373–391.
 
5.
Smith G.N. Jr. The role of collagenolytic matrix metalloproteinases in the loss of articular cartilage in osteoarthritis. Front Biosci. 2006; 11: 3081–3095.
 
6.
Heinegård D., Saxne T. The role of the cartilage matrix in osteoarthritis. Nat. Rev. Rheumatol. 2011; 7(1): 50–56. doi: 10.1038/nrrheum.2010.198.
 
7.
Wierusz-Kozłowska M., Markuszewski J., Woźniak W. Rola procesu zapalnego w patogenezie choroby zwyrodnieniowej stawów. Chir. Kolana Artroskopia Traumatol. Sport. 2005; 2(3): 19–24.
 
8.
Henrotin Y.E., Bruckner P., Pujol J.P. The role of reactive oxygen species in homeostasis and degradation of cartilage. Osteoarthritis Cartilage 2003; 11(10): 747–755.
 
9.
Valko M., Leibfritz D., Moncol J., Cronin M.T., Mazur M., Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int. J. Biochem. Cell. Biol. 2007; 39(1): 44–84.
 
10.
Ostalowska A., Birkner E., Wiecha M., Kasperczyk S., Kasperczyk A., Kapolka D., Zoń-Giebel A. Lipid peroxidation and antioxidant enzymes in synovial fluid of patients with primary secondary osteoarthritis of the knee joint. Osteoarthritis Cartilage 2006; 14: 139–145.
 
11.
Woolacott N.F., Corbett M.S., Rice S.J. The use and reporting of WOMAC in the assessment of the benefit of physical therapies for the pain of osteoarthritis of the knee: findings from a systematic review of clinical trials. Rheumatology (Oxford) 2012; 51(8): 1440–1446.
 
12.
Goldring M.B., Goldring S.R. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann. N Y Acad. Sci. 2010; 1192: 230–237.
 
13.
Koster J.F., Biemond P., Swaak A.J. Intracellular and extracellular sulphydryl levels in rheumatoid arthritis. Ann. Rheum. Dis. 1986; 45: 44–46.
 
14.
Oyanagui Y. Reevaluation of assay methods and establishment of kit for superoxide dismutase activity. Anal. Biochem. 1984; 142(2): 290–296.
 
15.
Paglia D.E., Valentine W.N. Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase. J. Lab. Clin. Med. 1967; 70: 158–169.
 
16.
Aebi H. Catalase in vitro. Methods Enzymol 1984; 105: 121–126.
 
17.
Erel O. A new automated colorimetric method for measuring total oxidant status. Clin. Biochem. 2005; 38(12): 1103–1111.
 
18.
Diehl P., Gerdesmeyer L., Schauwecker J., Kreuz P.C., Gollwitzer H., Tischer T. Conservative therapy of osteoarthritis. Orthopade 2013; 42(2): 125–139. doi: 10.1007/s00132-012-2016-6.
 
19.
Axe J.M., Snyder-Mackler L., Axe M.J. The role of viscosupplementation. Sports Med. Arthrosc. 2013; 21(1): 18–22. doi: 10.1097/JSA.0b013e3182673241.
 
20.
Strand V., Baraf H.S., Lavin P.T., Lim S., Hosokawa H. A multicenter, randomized controlled trial comparing a single intra-articular injection of Gel-200, a new cross-linked formulation of hyaluronic acid, to phosphate buffered saline for treatment of osteoarthritis of the knee. Osteoarthritis Cartilage 2012; 20(5): 350–6. doi: 10.1016/j.joca.2012.01.013. Epub 2012 Feb 1.
 
21.
Vincent H.K., Montero C., Conrad B.P., Horodyski M., Connelly J., Martenson M., Seay A.N., Vincent K.R. "Functional Pain," functional outcomes, and quality of life after hyaluronic acid intra-articular injection for knee osteoarthritis. PM R. 2013; 5(4): 310-318 doi: 10.1016/j.pmrj.2013.01.004.
 
22.
Pavelka K., Uebelhart D. Efficacy evaluation of highly purified intra-articular hyaluronic acid (Sinovial(®)) vs hylan G-F20 (Synvisc(®)) in the treatment of symptomatic knee osteoarthritis. A double-blind, controlled, randomized, parallel-group non-inferiority study. Osteoarthritis Cartilage 2011; 19(11): 1294–300. doi: 10.1016/j.joca.2011.07.016.
 
23.
Iannitti T., Rottigni V., Palmieri B. A pilot study to compare two different hyaluronic acid compounds for treatment of knee osteoarthritis. Int. J. Immunopathol. Pharmacol. 2012; 25(4): 1093–1098.
 
24.
Sumii H., Inoue H., Onoue J., Mori A., Oda T., Tsubokura T. Superoxide dismutase activity in arthropathy: its role and measurement in the joints. Hiroshima J. Med. Sci. 1996; 45: 51–55.
 
25.
Grisham M.B. Reactive oxygen species in immune responses. Free Radic Biol. Med. 2004; 36(12): 1479–1480.
 
26.
Karatas F., Ozates I., Canatan H., Halifeoglu I., Karatepe M., Colakt R. Antioxidant status and lipid peroxidation in patients with rheumatoid arthritis. Indian J. Med. Res. 2003; 118: 178–181.
 
27.
Köse K., Yazici C., Cambay N., Așcioǧlu O., Dogan P. Lipid peroxidation and antioxidant enzymes in patients with Behçet’s disease. Tohoku J. Exp. Med. 2002; 197(1): 9–16.
 
28.
Carlo M.D., Loeser R.F. Increased oxidative stress with aging reduces chondrocyte survival: correlation with intracellular glutathione levels. Arthritis Rheum. 2003; 48: 3419–20.
 
29.
Łukaszewicz-Hussain A. The role glutathione and glutathione – related enzymes in antioxidative processes. Med. Pr. 2003; 54(5): 473–479.
 
30.
Surapaneni K.M., Venkataramana G. Status of lipid peroxidation, glutathione, ascorbic acid, vitamin E and antioxidant enzymes in patients with osteoarthritis. Indian J. Med. Sci. 2007; 61(1): 9–14.
 
eISSN:1734-025X
Journals System - logo
Scroll to top