Onu Ilie, Gherghel Robert, Nacu Isabella, Cojocaru Florina-Daniela, Verestiuc Liliana, Matei Daniela-Viorelia, Cascaval Dan, Serban Ionela Lacramioara, Iordan Daniel Andrei, Tucaliuc Alexandra, Galaction Anca-Irina
Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy "Grigore T. Popa", 700454 Iasi, Romania.
Department of Physiotherapy, Micromedica Clinic, 610119 Piatra Neamt, Romania.
Biomedicines. 2024 Feb 17;12(2):449. doi: 10.3390/biomedicines12020449.
Known as the degenerative disease of the knee with the highest prevalence, knee osteoarthritis (KOA) is characterized by a gradual destructive mechanism that, in severe cases, can provoke the need for total knee substitution. As the disease progresses, various enzymatic, immunological, and inflammatory processes abnormally degrade hyaluronic acid (HA), SF's main component, and affect the concentrations of specific proteins, with the final results seriously endangering synovial fluid (SF)'s rheological and tribological features and characteristics. No effective treatments have been found to stop the progression of KOA, but the injection of HA-based viscoelastic gels has been considered (alone or combined with physiotherapy (PT)) as an alternative to symptomatic therapies. In order to evaluate the effect of viscosupplementation and PT on the characteristics of SF, SF aspirated from groups treated for KOA (HA Kombihylan and groups that received Kombihylan and complex PT) was analyzed and compared from analytical, spectrophotometrical, and rheological perspectives. In the patients treated with PT, the SF extracted 6 weeks after viscosupplementation had a superior elastic modulus (G') and viscous moduli (G″), as well as a homogeneous distribution of proteins and polysaccharides. The viscosupplementation fluid improved the bioadhesive properties of the SF, and the use of the viscosupplementation fluid in conjunction with PT was found to be favorable for the distribution of macromolecules and phospholipids, contributing to the lubrication process and the treatment of OA-affected joints.
膝关节骨关节炎(KOA)是一种已知患病率最高的膝关节退行性疾病,其特点是具有渐进性破坏机制,在严重情况下可能需要进行全膝关节置换。随着疾病进展,各种酶促、免疫和炎症过程会异常降解透明质酸(HA)(滑液的主要成分),并影响特定蛋白质的浓度,最终结果会严重危及滑液(SF)的流变学和摩擦学特性。目前尚未发现有效的治疗方法来阻止KOA的进展,但注射基于HA的粘弹性凝胶已被视为(单独或与物理治疗(PT)联合使用)对症治疗的替代方法。为了评估粘弹性补充疗法和PT对滑液特性的影响,从分析、分光光度和流变学角度对从接受KOA治疗的组(HA康彼身和接受康彼身及综合PT的组)抽取的滑液进行了分析和比较。在接受PT治疗的患者中,粘弹性补充疗法后6周抽取的滑液具有更高的弹性模量(G')和粘性模量(G''),以及蛋白质和多糖的均匀分布。粘弹性补充液改善了滑液的生物粘附特性,并且发现粘弹性补充液与PT联合使用有利于大分子和磷脂的分布,有助于润滑过程和OA受累关节的治疗。
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