Department of Medical Rehabilitation-Orthopedics and Traumatology, National Institute of Rehabilitation, Physical Medicine and Balneoclimatology, 2 Sf. Dumitru Street, Sector 3, 030167 Bucharest, Romania.
Department of Rehabilitation, University of Medicine and Pharmacy "Carol Davila", 8 Eroii Sanitari Street, Sector 5, 050474 Bucharest, Romania.
Biomolecules. 2024 Jul 11;14(7):832. doi: 10.3390/biom14070832.
The objective of the present study was to assess the effect of intra-articular Hyaluronic acid (HA) and Chondroitin sulfate (CS) supplementation (Hialurom Hondro (HH)) on pain symptoms and joint mobility. In total, 60 mg/mL sodium hyaluronate and 90 mg/mL CS were administered to 21 patients (17 females and 4 males) respecting the in-force requirements, excluding patients with some specific comorbidities. In addition to the clinical study (where the pain intensity (severity) and joint mobility were assessed), rheological characterization was conducted evaluating the following parameters: elastic modulus (G'), loss modulus (G″) oscillatory frequency (fc) at 0.5 Hz and 2.5 Hz, crossover frequency (fc), relaxation time (λ) where it was noticed that the addition of chondroitin sulfate (CS) to sodium hyaluronate (SH) significantly enhances and improves the viscoelastic properties, particularly at higher shear frequencies. A significant decrease in pain intensity felt by the subjects was found, from 7.48 (according to Wong-Baker scale)-pain close to 8 (the patient is unable to perform most activities), to more reduced values of 5.86-at 6 weeks after injection, 4.81-at 3 months after injection, and 5.24-at 6 months after injection, improvements in symptoms was fast and durable. Data related to the evolution of joint mobility show that at 6 weeks after injection, the mobility of joints increased by 17.8% and at 6 months by 35.61%. No serious adverse events were reported with undesired effects so that they would impose additional measures. Better resistance to enzymatic degradation and free radicals could be expected from the synergic combination of sodium hyaluronate and chondroitin sodium sulfate, this having a special importance for the patients, granting them the ability to perform more ample movements and reducing dependency on attendants, thus increasing quality of life.
本研究旨在评估关节内透明质酸（HA）和硫酸软骨素（CS）补充剂（Hialurom Hondro（HH））对疼痛症状和关节活动度的影响。共向 21 名患者（17 名女性和 4 名男性）给予 60mg/mL 透明质酸钠和 90mg/mL CS，以符合现行规定，排除有某些特定合并症的患者。除了临床研究（评估疼痛强度（严重程度）和关节活动度）外，还进行了流变学特征评估，评估了以下参数：弹性模量（G'）、损耗模量（G"）、在 0.5Hz 和 2.5Hz 下的振荡频率（fc）、交叉频率（fc）、松弛时间（λ）。结果发现，硫酸软骨素（CS）添加到透明质酸钠（SH）中显著增强和改善了粘弹性特性，特别是在较高剪切频率下。发现患者的疼痛强度显著降低，从 7.48（根据 Wong-Baker 量表）-接近 8 级（患者无法进行大多数活动），到 6 周后注射时的 5.86 级、3 个月后注射时的 4.81 级和 6 个月后注射时的 5.24 级，症状改善迅速且持久。与关节活动度的演变相关的数据表明，注射后 6 周时，关节活动度增加了 17.8%，6 个月时增加了 35.61%。没有报告严重的不良事件和不良影响，因此无需采取额外措施。预计透明质酸钠和硫酸软骨素钠的协同组合具有更好的抵抗酶降解和自由基的能力，这对患者具有特殊意义，使他们能够进行更广泛的运动，减少对护理人员的依赖，从而提高生活质量。
