Preprint Communication Version 1 Preserved in Portico This version is not peer-reviewed

Physicochemical Characterization of Hyaluronic Acid Vascosupplemented Synovial Fluid in Combination with Physiotherapy in Knee Osteoarthritis

Ilie Onu
† ORCID logo ,
Robert Gherghel
*,† ,
Isabella Nacu
ORCID logo ,
Florina-Daniela Cojocaru
ORCID logo ,
Liliana Verestiuc
ORCID logo ,
Daniela-Viorelia Matei
,
Ioana Buculei
ORCID logo ,
Dan Cascaval
ORCID logo ,
Ionela Lacramioara Serban
,
Daniel Andrei Iordan
* ORCID logo ,
Alexandra Tucaliuc
,
Anca-Irina Galaction
†
These authors contributed equally to this work
Version 1 : Received: 3 May 2023 / Approved: 4 May 2023 / Online: 4 May 2023 (08:42:51 CEST)

A peer-reviewed article of this Preprint also exists.

Onu, I.; Gherghel, R.; Nacu, I.; Cojocaru, F.-D.; Verestiuc, L.; Matei, D.-V.; Cascaval, D.; Serban, I.L.; Iordan, D.A.; Tucaliuc, A.; et al. Can Combining Hyaluronic Acid and Physiotherapy in Knee Osteoarthritis Improve the Physicochemical Properties of Synovial Fluid? Biomedicines 2024, 12, 449. https://doi.org/10.3390/biomedicines12020449 Onu, I.; Gherghel, R.; Nacu, I.; Cojocaru, F.-D.; Verestiuc, L.; Matei, D.-V.; Cascaval, D.; Serban, I.L.; Iordan, D.A.; Tucaliuc, A.; et al. Can Combining Hyaluronic Acid and Physiotherapy in Knee Osteoarthritis Improve the Physicochemical Properties of Synovial Fluid? Biomedicines 2024, 12, 449. https://doi.org/10.3390/biomedicines12020449

Abstract

Knee Osteoarthritis (KOA), the most common knee degenerative disease, involve a slow destructive process, leading to disability and ultimately total knee replacement. The progression of KOA is related to the loss of rheological properties of the synovial fluid (SF), due to slow immunological, inflammatory and enzymatic processes that cleave the hyaluronic acid (HA) and decrease the concentration of specific proteins. Since no effective treatments have been found to halt the progression of KOA, injection of HA-based viscoelastic gels combined with physiotherapy (PT) is an alternative to symptomatic therapies. In order to evaluate the effect of viscosupplementation and PT on the SF characteristics, the SF aspirated from the KOA was spectrophotometrically and rheological analyzed, comparing the receiving groups of HA Kombihylan® and groups that received Kombihylan® and complex PT. In patients treated with PT, SF extracted 6 weeks after viscosupplementation had a superior elastic moduli (G') and viscous moduli (G") profile behavior, having a homogeneous distribution of proteins and polysaccharides in the SF, stimulating stronger interactions. In the absence of PT the G' and G" profiles are non-uniform, suggesting an unorganized supplemented SF with some clustering phenomena, proteins aggregation and a low level of entanglement between HA and macromolecular components in the SF.

Keywords

knee osteoarthritis; synovial fluid; hyaluronic acid; physical therapy; ATR-FTIR spectroscopy; rheological properties; bioadhesion

Subject

Medicine and Pharmacology, Other

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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