Injectable Hyaluronic Acid

Osteoarthritis is the most common disease of the joints, it is characterized by inflammation - wear of the elements that form a joint and mainly concerns the supporting joints (knees, hips). It starts with wear and tear of the articular cartilage, in the form of chondropathy at younger ages and degeneration in older, which then affects the subchondral bone, the synovial membrane and then other periarticular structures such as ligaments and tendons.

The main symptoms include pain during movement initially but also at rest in advanced stages, tenderness to the touch or massage, stiffness with progressive limitation of range of motion, stiffness during movement and finally deformity of the joint either due to osteophytes or finally with disorder of the joint axis.

The role of hyaluronic acid in the joint
Hyaluronic acid is a naturally occurring substance in synovial fluid that provides lubrication and protection to the joint. Hyaluronic acid, due to its significant viscosity, is inserted between the joint surfaces and acts as a lubricant but also absorbs the vibrations that are exerted during the movement of the joint, especially in the loaded joints. As a lubricant, hyaluronic acid achieves, under normal conditions, a coefficient of friction of 0.02 and less. Hyaluronic acid even serves to absorb the forces exerted on the articular cartilage during the intense movement of the joint. The high viscosity of its molecule due to its volume, its high molecular weight and the arrangement of its molecules in space, allows it to intervene between the articular surfaces, like a plastic body, to store energy in its network and to absorb vibrations.

Hyaluronic acid is also a structural component of proteoglycans, the molecules that are located in the articular cartilage, retain water and enhance the elasticity of articular cartilage. Its presence helps in their composition and aggregation. Without proteoglycans, the articular cartilage loses its elasticity, acquires cracks in every movement of the joint and is eventually destroyed, leading to osteoarthritis.

An additional role of hyaluronic acid is to transport low molecular weight metabolites and nutrients, mainly sugar from synovial fluid to synovial cartilage but also useless metabolic derivatives of chondrocyte metabolism, via synovial fluid, to the vascular expelled from the body. This transfer is assisted by the movement of the joint. Hyaluronic acid also has anti-inflammatory and antioxidant properties modifying the inflammatory reaction, but only when it has a high molecular weight.

With age but also under the influence of various exogenous factors, in the joints not only is a reduction in the production of hyaluronic acid but also the little that is produced has a low molecular weight. The reduction of its molecular weight gradually causes a decrease in its viscoelasticity and its rheological, defense and nutritional properties. The joint is no longer protected and is progressively destroyed, causing the degenerative lesions of osteoarthritis.

So, in addition to the classic indication of degenerative Osteoarthritis of the Knee and other large joints, the use of Hyaluronic acid, thanks to its lubricating and moisturizing action, can be effective in a number of other diseases such as:
• Chondropathy - Chondromalacia of the Knee - Knee
• Hypochromic Shoulder Friction Syndrome
• Symphytic Bursitis of the Shoulder (Frozen Shoulder)
De Quervain tendonitis and tendon trapping syndromes in general
Osteoarthritis of the base of the thumb
• Metatarsalgia - Flexor tendonitis of the metatarsal muscles