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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

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.

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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

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