da Costa Sergio Ricardo, da Mota E Albuquerque Roberto Freire, Helito Camilo Partezani, Camanho Gilberto Luis
PhD Program for Musculoskeletal System Sciences, Instituto de Ortopedia e Traumatologia, Hospital das clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, 333 Ovídio Pires de Campos St., Cerqueira César, São Paulo, SP 05403-010, Brazil.
Knee Surgery Division, Instituto de Ortopedia e Traumatologia, Hospital das clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Ther Adv Musculoskelet Dis. 2021 May 13;13:1759720X211015005. doi: 10.1177/1759720X211015005. eCollection 2021.
Patellar chondropathy has a high incidence in the general population, being more common in patients younger than 50 years, female and recreational athletes, and overweight and obese patients. The most common complaints are pain, limited mobility, crepitus, difficulty climbing and descending stairs, and joint instability, usually showing unsatisfactory results with anti-inflammatory, physiotherapy, rehabilitation, and many other conservative treatment methods. The presumed hyaluronic acid (HA) disease-modifying activity may include effects on cartilage degradation, endogenous HA synthesis, synoviocyte and chondrocyte function, and other cellular inflammatory processes. Currently, HA is widely used as a safe and effective conservative treatment for osteoarthritis in the knee and other joints. HA improves the physiological environment in an osteoarthritic joint and the shock absorption and lubrication properties of the osteoarthritic synovial fluid, thus restoring the protective viscoelasticity of the synovial HA, reducing the pain, and improving the mobility. The complete mechanism of HA in the joint is not fully understood, but a wide range of actions in the joint is recognized. Its anti-inflammatory, analgesic, and chondroprotective action is related to the modulation of the intra- and extracellular inflammation cascade. HA has been shown to be safe and effective in the treatment of pain related to patellar chondropathy.
髌软骨病在普通人群中发病率较高，在50岁以下患者、女性、业余运动员以及超重和肥胖患者中更为常见。最常见的症状是疼痛、活动受限、摩擦音、上下楼梯困难以及关节不稳定，通常抗炎、物理治疗、康复治疗和许多其他保守治疗方法的效果都不尽人意。推测透明质酸（HA）的疾病改善活性可能包括对软骨降解、内源性HA合成、滑膜细胞和软骨细胞功能以及其他细胞炎症过程的影响。目前，HA被广泛用作膝关节和其他关节骨关节炎的一种安全有效的保守治疗方法。HA可改善骨关节炎关节的生理环境以及骨关节炎滑液的减震和润滑特性，从而恢复滑膜HA的保护性粘弹性，减轻疼痛并改善活动能力。HA在关节中的完整作用机制尚未完全了解，但人们认识到它在关节中有广泛的作用。其抗炎、镇痛和软骨保护作用与细胞内和细胞外炎症级联反应的调节有关。HA已被证明在治疗与髌软骨病相关的疼痛方面是安全有效的。
