- Published:
Hyaluronic Acid in Synovial Fluid
Hyaluronsyra i synovialvätska: VI. Effekt av intraartikulära hyaluron-syreinfektioner på symtom vid arthrittillstånd hos kapplöpningshäster
VI. Effect of Intra-Articular Injection of Hyaluronic Acid on the Clinical Symptoms of Arthritis in Track Horses
Acta Veterinaria Scandinavica volume 11, pages 139–155 (1970)
Abstract
Twelve horses with traumatic arthritis were treated with intraarticular injection of hyaluronic acid mixed with cortisone and the results compared with 6 horses treated only with cortisone. There was a significantly better improvement in the group injected with a mixture of hyaluronic acid and cortisone. Further studies have given the same results in traumatic arthritis in horses if hyaluronic acid alone is injected.
After injection of hyaluronic acid a large number of granulated monocytes appeared in the synovial fluid, but no inflammatory signs were observed. It is possible that this macrophage invasion is instrumental in producing improvement in the condition of the joint. The injected hyaluronic acid may also adhere to the surface of articular cartilage producing an “clastic cushion” protecting the cartilage surface.
Experimental mechanical damage was also inflicted on the surface of articular cartilage in dogs and monkeys, and smoother healing was achieved if hyaluronic acid was injected into the joints after the damage.
Injections of hyaluronic acid seem to be of value in treating traumatic arthritis or similar conditions.
Sammanfattning
Tolv hästar med traumatisk arthrit har behandlats med intraartikulära hyaluronsyre-cortisoninjektioner och resultatet jämförts med 6 fall som endast behandlats med intraartikulära cortisoninjektioner. De hästar som behandlades med hyaluronsyra-cortisoninjektioner uppvisade en signifikant förbättring jämfört med kontrollgruppens. Senare studier har visat att samma goda resultat kan erhållas om enbart hyaluronsyra injiceras intraartikulärt vid traumatiska arthriter.
Efter intraartikulära injektioner av hyaluronsyra uppträder ett stort antal granulerade monocyter i synovialvätskan men inga kliniska tecken på inflammation kan observeras. Det är möjligt att det ökade antal macrophager som uppträder i ledvätskan efter hyaluronsyreinjektion har betydelse för den observerade bättringen av ledsjukdomen. Den injicerade hyaluronsyran kan också tänkas bilda en tunn film på ledbroskets yta och på så sätt bilda en elastisk kudde, vilken skyddar broskytan mot nötning och även fungerar som en stötdämpare.
Mekanisk skada som åstadkommits i ledbrosket hos hundar och åsnor visade en förbättrad läkning, om leden efter skadans uppkomst behandlades med hyaluronsyreinjektioner.
Det förefaller som intraartikulära hyaluronsyreinjektioner vid traumatiska arthriter och liknande sjukdomstillstånd är av värde vid behandlingen av dessa tillstånd.
References
Balazs E. A.: Physical chemistry of hyaluronic acid. Fed. Proc. 1958, 17, 1086–1093.
Balazs E. A.: Physiology of the vitreous body. In Importance of the Vitreous Body in Retina Surgery with Special Emphasis on Reoperations, ed. G. L. Schepens, G. V. Mosby, St. Louis 1960, 29–48.
Balazs E. A.: Sediment volume and viscoelastic behaviour of hyalu-ronic acid solutions. Fed. Proc. 1966, 25, 1817–1822.
Balazs E. A.: Viscoelastic properties of hyaluronic acid and biological lubrication. Univ. Mich. Med. Gtr.J., Special Issue Dec. 1968, 255–259.
Balazs E. A.: Some aspects of the aging and radiation sensitivity of the intercellular matrix with special regard to hyaluronic acid in synovial fluid and vitreous. In Thüle International Sympo-sium: Aging of Connective and Skeletal Tissue, ed. A. Engel & T. Larsson. Nordiska Bokhandels Förlag, Stockholm 1969.
Balazs E. A. & L. Piller: The formation of synovial fluid. Magy. orv. Arch. 1943, U, 3–7.
Balazs E. A. & D. B. Sweeney: The replacement of the vitreous body in the owl monkey by reconstituted vitreous and by hyaluronic acid. Mod. Probi. Ophthal. (Basel) 1966, 4, 230–232.
Balazs E. A., G. D. Bloom & D. A. Swann: Fine structure and glycos-aminoglycan content of the surface layer of articular cartilage. Fed. Proc. 1966, 25, 1813–1816.
Balazs E. A., P. O. Seppälä, D. A. Gibbs, I. F. Duff, E. W. Merrill: Effect of aging on the viscoelastic and chemical properties of human synovial fluid. Arthr. and Rheum. 1967, 10, 264.
Balazs E. A. & D. B. Sweeney: The injection of hyaluronic acid and reconstituted vitreous into the vitreous cavity. In New and Controversial Aspects of Retinal Detachment, ed. A. McPherson. Hoeber Medical Division, New York 1968, 371–376.
Balazs E. A., P. O. Seppälä, L F. Duff: Hyaluronic acid in synovial fluid. V. Effect of repeated intra-articular hydrocortisone in-jections on the viscoelastic and chemical properties of rheuma-toid synovial fluid. Arthr. and Rheum. 1970. In press.
Blix G. & O. Snellman: On chondroitin sulphuric acid and hyaluronic acid. Arkiv Kemi 1945, 19A, 1–19.
Blumberg B. S. & A. G. Ogston: The effects of proteolytic enzymes on the hyaluronic acid complex of ox synovial fluid. Biochem. J. 1957, 66, 342–346.
Branemark P.-I. Sc L. Goldie: Observations on the action of predni-solone tertiary butyl acetate (Codelcortone TBA) and methyl-prednisolone acetate (depomedrone) on normal soft tissues. Acta rheum, scand. 1967, 13, 241–256.
Bruckschen E. G.: Gewebsreaktionen nach Implantation von Hyaluron-säure. (Tissue reaction after hyaluronic acid installment). Exuerientia (Basel) 1957, 19, 289–290.
Chandler G. N. & V. Wright: The deleterious effect of intra articular hydrocortisone injections. Lancet 1958, 2, 661–663.
Chandler G. N., D. T. Jones, V. Wright & S. J. Hartfall: Charcot’s arthropathy following intra-articular hydrocortisone. Brit. med. J. 1959, 1, 952–953.
Curri S. B. & E. Campailla: Acido jaluronico e condrogenesi: influenza del mucopolysaccharide sui processi riparativi della dartilagine. (Hyaluronic acid and chondrogenesis: the influence of muco-polysaccharides on cartilage repair). Biochem. Biol. sper. 1967, 6, 32–71.
Gibbs D. A., E. W. Merrill, K. A. Smith & E. A. Balazs: The rheology of hyaluronic acid. Biopolymers 1968, 6, 111–791.
Laurent T. C.: Physico-Chemical Studies on Hyaluronic Acid. Akade-misk Avhandling, Almquist & Wiksell, Uppsala 1957.
McKay A. G.: Articular cartilage erosion. Canad. vet. J. 1967, 8, 134–135.
Meyers K. R., S. Negami & R. K. White: Dynamic mechanical prop-erties of synovial fluid. Biorheology 1966, 3, 197–209.
O'Connor J. T.: The untoward effects of cortical steroids in the horse. J. Amer. vet. med. Ass. 1968, 153, 1614–1617.
Ogston A. G. & J. E. Stanier: The physiological function of hyaluronic acid in synovial fluid: viscous; elastic; and lubricational prop-erties. J. Physiol. (Lond.) 1953, 119, 244–252.
Preston B. N., M. Davies & A. G. Ogston: The composition and phy-siochemical properties of hyaluronic acids prepared from ox synovial fluid and from a case of mesothelioma. Biochem. J. 1965, 96, 449–474.
Rydell N. & E. A. Balazs: Synovial joint reaction after injection of hyaluronic acid. In progress.
Salter R. B., A. Gross & J. H. Hale: Hydrocortisone arthropathy: an experimental investigation. Canad. med. Ass. J. 1967, 97, 374–377.
Scott J. E.: Alipathic ammonium salts in the assay of acid polysac-charides from tissues. Meth. biochem. Anal. 1960, 8, 145–197.
Seppälä P. O. & E. A. Balazs: Hyaluronic acid in synovial fluid. III. Effect of maturation and aging on the chemical properties of bovine synovial fluid of different joints. J. Geront. 1969, 24, 309–314.
Seppälä P. O., E. A. Balazs & I. F. Duff: Hyaluronic acid in synovial fluid. II. Effect of aging on the chemical properties of human synovial fluid. Arthr. and Rheum. 1970a. In press.
Seppälä P. O., D. A. Gibbs & E. A. Balazs: Hyaluronic acid in syno-vial fluid. IV. Viscoelasticity of human and bovine synovial fluid during aging and in various pathological conditions. Bio-chim. biophys. Acta (Amst.) 1970b. In press.
Stracker O. A.; Synovia und degenerative Gelenkserkrankungen. (The synovium and degenerative joint diseases). Z. Orthop. 1967, 4, 424–432.
Sundblad L.: Glycosaminoglycans and glycoproteins in synovial fluid. In The Amino Sugars, vol. 2-A. Distribution and Biological Role, 230–250. ed. E. A. Balazs & R. W. Jeanloz. Academic Press, New York 1965.
Swann D. A.: Studies on hyaluronic acid. 1. Preparation and proper-ties of rooster comb hyaluronic acid. Biochim. biophys. Acta (Amst.) 1968, 156, 17–30.
Zacharic L.: The deleterious effect of corticosteroids administration topically in particular intra-articularly. Acta orthop. scand. 1965, 36, 127–136.
Österlin S. & E. A. Balazs: Macromolecular composition and fine struc-ture of the vitreous in the owl monkey. Exp. Eye Res. 1968, 7, 534–545.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rydell, N.W., Butler, J. & Balazs, E.A. Hyaluronic Acid in Synovial Fluid. Acta Vet Scand 11, 139–155 (1970). https://doi.org/10.1186/BF03547976
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1186/BF03547976