Hyaluronic acid for joints: drugs, tablets, injections

Means with hyaluronic acid for joints (ointments and creams, tablets, injections): application features + reviews

Hyaluronic acid is a substance produced by the human and animal body. It is present in many tissues of the body and participates in the processes of their regeneration. At present, the substance is widely used both in cosmetology and for the treatment of various pathologies of joints.

What is hyaluronic acid

Hyaluronic acid (hyaluronate) is glycosaminoglycan, which is present in biological fluids, connective tissue, epithelium, nerve fibers and is produced by the human body itself.Particularly important role hyaluronic acid plays in the normal functioning of the joints.

Joints have the following structure: articular surfaces of bones covered with hyaline cartilage, inside of the wall of the joint capsule lining the synovial membrane, which produces synovial fluid. Cartilage receives nutrition from bone tissue and synovial fluid, which acts as a lubricant for the joints. Hyaluronic acid is a part of this liquid.

Functions of hyaluronic acid

When the hyaluronic acid content in the synovial fluid decreases, the friction of the joint surfaces increases, friend, the tissues of the joint begin to wear out intensively, the hyaline cartilage is thinned, which can be accompanied by an inflammatory process. This leads to pain in the joint and restriction of movement.

Her injection injection into the joint cavity is called "liquid prosthetics since the properties of the acid are similar to those of a natural natural lubricant, synovial fluid.

Artificially obtained by laboratory method hyaluronic acid is a completely natural product, which is most often synthesized by Streptococcus bacteria.

An acid of animal origin, which can be obtained from animal tissues, is not completely possible clear of protein compounds, therefore, when it is used, allergic reactions are likely and rejection.

Some manufacturers of drugs necessarily indicate that the constituent acid is not of animal origin, but bacterial.

Myths about hyaluronic acid - video

Indications for use

As a medical preparation for joints, hyaluronic acid belongs to a group of delayed action agents.

Most often it is used for arthrosis (knee, hip, shoulder, elbow and other joints).

In the first place in the prevalence is gonarthrosis (arthrosis of the knees), while for the application of hyaluronic acid, the cause of the pathology does not matter.

However, a good effect of hyaluronate gives only at the initial stages of the disease, when the ability of cartilage tissues to restore is not yet disturbed.With neglected arthrosis, proceeding against the background of arthritis, it can be completely useless.

Also, hyaluronic injections are prescribed:

• as chondroprotectors or blockade of pain syndrome;
• during rehabilitation after trauma;
• To protect hyaline cartilage from possible mechanical damage;
• after arthroscopy (diagnostic invasive penetration into the joint cavity).

Acid-based preparations favorably and complexly affect the functioning of the joints, namely:

• increase the viscosity and the amount of synovial fluid, thereby reducing the friction of the joint surfaces during movement, and improving the damping properties of the joint;
• strengthen nutrition and regeneration (restoration) of articular cartilage;
• reduce inflammation.

Thus, there is a weakening of the symptoms of arthrosis until their complete disappearance.

The main and perhaps the only drawback of treatment with hyaluronic acid is its high cost. The price of one injection is from 3 to 5 thousand rubles.

Also, you should add the cost of the procedure (direct administration of the drug) - from 500 to 1500 rubles. depending on the joint.

Since the course usually consists of 3-5 procedures, and in 6-12 months, as a rule, its recurrence is recommended, all this results in a considerable amount.

Methods of treating joints with hyaluronic acid

Injections

The main way to use hyaluronic acid for the treatment of joints is by injections.

Thanks to them, pain and puffiness passes, the crunch and discomfort decreases with movements in the joint, and their amplitude increases.

Such therapy has practically no serious contraindications and can be carried out at any age.

Intra-articular injection

To treat degenerative joint damage with the help of acid began in the 70s of the last century.

The drug was called Hyaluronic acid.

Modern pharmacology offers a large number of products that include hyaluronate, foreign and domestic production:

• Fermatron(United Kingdom).Structurally modified agent that prevents the destruction of hyaline cartilage; contains 2 mg of active substance (hyaluronate) in 20 mg of solution.
• Suplazine(Ireland).Sodium hyaluronate, which serves as a kind of synovial fluid implant, is produced in syringes of 20 and 60 mg.
• Ostenil (Switzerland).Viscoelastic implant is available as a 1% solution of 10, 20 or 40 mg.
• Synocrome(Austria).A complex preparation that improves the condition of the cartilaginous tissue is released in the form of 1% and 2% sodium hyaluronate solution at 10 and 20 mg.

The following preparations are used less frequently:

• Synwisk(USA).A preparation having a viscoelastic consistency; reduces friction, thereby ensuring joint protection.
• Viscosil(Germany).,% solution of hyaluronic acid, it is often used after arthroscopy; reduces pain, improves joint performance.
• Viscorneal(France).It enhances the viscosity of the synovial fluid, binds free radicals, and has an anti-inflammatory effect.
• Adante(Japan).Produced in a dosage of 25 mg of hyaluronate.
• Hyastat (Russia).Produced in the form of hydrogel in a dosage of 20 mg.

Funds based on hyaluronate in the photo

Synchrome forte

All preparations with sodium hyaluronate for the replacement of synovial fluid are released in sterile disposable syringes. Their shelf life is about three years.

The number of injections depends on the severity of the pathological process, on average the standard course consists of 3-5 injections, one injection per week is made.Simultaneous administration of the drug in several joints is possible. If necessary, the course is repeated after 6-12 months.

Treatment can be carried out both in hospital and outpatient settings. If the disease is not too neglected, you can not change your lifestyle, but it is advisable to reduce the burden on the joint during the treatment period.

For intraarticular injections, the following rules should be observed:

• They are carried out only in conditions of complete sterility.
• When administering the drug, damage to the blood vessels should be avoided.
• Injection can only be done by a doctor of the appropriate category, medical sisters and paramedics to such procedures are not allowed.

If there is an inflammatory process in the joint, you must first remove the inflammation, for this purpose, corticosteroids are prescribed.

In inflammation, severe pain, swelling and increased local temperature are usually accompanied by intraarticular effusion (excessive production of synovial fluid), which significantly reduces the effectiveness of injections of hyaluronic acid acid.

The introduction of hyaluronate into the hip joint (unlike other joints) is performed under X-ray control, since it is located deep beneath a layer of subcutaneous tissue and muscles.

Means for oral and external use

Hyaluronate in the form of tablets has a beneficial effect on the whole body, but it is not able to cure the disease of the joints

Currently, new drugs with hyaluronic acid for joints in the form of tablets and external products (ointments and creams) are widely advertised.

Of course, taking a pill or using a cream is much easier and cheaper than taking an injection.

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However, it should be borne in mind that all these drugs are not medicinal products, but dietary supplements (biologically active additives), and the effect of their use is negligible.

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Tablets with hyaluronic acid have a complex effect on the entire body, namely improve the condition:

• skin (skin becomes more elastic and elastic, wrinkles are smoothed out);
• organs of vision (the eyeball is well moistened, the sensation of "sand" in the eyes and heaviness of the eyelids passes);
• joints (a characteristic crunch disappears, mobility increases).

All these effects manifest themselves only after 2-3 months from the beginning of taking the drug.Hyaluronic acid is used by the whole body, and joints get only a negligible part of it.Therefore, with serious problems with a specific joint, local injections are recommended.

When oral intake of hyaluronic acid preparations, the digestive organs perceive them in the same way as the cold from the pork legs (which also contains a significant amount of this acid).

Therefore, there is no difference between two portions of jelly or several capsules with hyaluronate. Studies of the efficacy of these agents have not been conducted, so it is comparable to the placebo effect.

Contraindications and precautions

The use of preparations based on hyaluronic acid has the following contraindications:

• hypersensitivity to the main or additional components of the drug;
• presence of skin diseases (dermatitis, eczema) or mechanical damage (wounds, scratches) at the site of the planned injection;
• inflammatory process in the joint, swelling and stasis of lymph;
• diabetes;
• unstable angina;
• infectious diseases, fever;
• age to 18 years;
• pregnancy and lactation.

As a rule, injections of hyaluronate are transferred well, in some cases there are such local manifestations as:

• burning, itching, a feeling of heat at the injection site;
• redness of the skin;
• edema of tissues;
• pain in the muscles, which quickly passes.

Usually external side effects occur within 10 minutes.If this does not happen, then cold compress can be applied to the joint, for example, dry ice.

Feedback on application

Dmitriy
http://weborto.net/forum/1226077100

Lyudmila
http://weborto.net/forum/1226077100

Maria Petrovna
http://evehealth.ru/ukoly-gialuronovoy-kisloty-v-kolenny-sustav/

Of all the methods of using hyaluronic acid in the treatment of joint diseases, intraarticular injections are most effective. However, any use of hyaluronate provides only a temporary effect - the course of treatment should be repeated periodically.

• Justina Nikolaeva
• Print this

A source: http://spina-sustav.ru/lechenie-sustavov/gialuronovaya-kislota-dlya-lecheniya-sustavov-mif.html

Hyaluronic acid for joints: preparations and reviews about them

Dry figures of statistics show that one in five people suffer from this or that disease of joints on the planet, Russians among them are about twenty million people.

Dystrophic joint changes (osteochondrosis, arthrosis and others) are accompanied by dehydration and destruction of the cartilaginous tissue.

One of the most important components that make up the connective tissue and contained in human biological fluids is hyaluronic acid.

For joints, this natural substance can become a real salvation, as it increases mobility and reduces pain.

A 100% substitute for natural synovial fluid in human joints - hyaluronic acid - increases its viscosity, participates in nutrition and recovery structure of the hyaline cartilage, and also improves the sliding (even almost destroyed) of the cartilaginous structures in the shoulder, hip and knee joints, facilitating movement rights. How does this happen?

Healthy and sick joints: the importance of drugs based on hyaluronic acid

The structure of a healthy joint includes the surfaces of bones covered with whole hyaline cartilage, the synovial membrane lining the inside of the wall articular capsule, as well as synovial fluid lubricating the joint surfaces and, due to the viscoelastic properties, damping at movement. The hyaline cartilage covering the bone tissue is fed from the underlying layers, as well as from the synovial fluid. In healthy joints, it has an elastic and dense structure, washing its fluid lubricates the surface and thereby greatly facilitates the sliding of bones inside the joints. In patients suffering from osteoarthritis, as well as in people over the age of 50, the synovial fluid loses its lubricating and protective properties. Its quantity in articular tissues sharply decreases. Cartilage tissue loses its dense structure, the friction of the articular surfaces intensifies and leads to inflammatory processes in nearby areas and the appearance of pain. Hyaluronic acid for joints performs an identical function as synovial fluid, since it is considered an excellent alternative - "liquid prosthesis" - as doctors call it.

Application of hyaluronic acid preparations for joints

The number of intraarticular injections, through which drugs with hyaluronate are injected into a cavity located near with affected hyaline cartilage, depends on the severity of the disease, the degree of tissue damage and is 3-5 injections per course.

The courses are repeated as prescribed by the doctor: in six months or a year. Hyaluronic acid preparations for joints are introduced both in hospital and in clinics.

If the joints are not severely affected, then the doctors can allow the patient not to change the habitual rhythm of life, but it is advisable to reduce the load on the knee or shoulder joint during the treatment.

This is due to the abundant intra-articular effusion, which hyaluronic acid preparations for joints dilute so much that their effectiveness is markedly reduced. After the inflammatory process, thanks to the course of corticosteroids, will abate, the use of hyaluronic acid can give a more pronounced therapeutic result.

Hyaluronic acid (injections for joints): what is the effect?

Intra-articular administration of preparations based on hyaluronate affects the three main painful processes in the joints: increasing the viscosity and quantity synovial fluid hyaluronic acid helps to reduce the friction of the joint surfaces and increase its cushioning qualities when moving; she is enhances nutrition of chondrocyte cells and provides regeneration of hyaline cartilage; prevents inflammation and reduces their severity signs. Thus, hyaluronic acid for joints is an excellent means of reducing the symptoms of arthrosis and improving the quality of life. This safe gel implant reduces the load on the joint, nourishes the cartilaginous tissue and forms a natural prosthesis identical to the human synovial fluid.

Varieties of drugs with hyaluronic acid for joints

To treat lesions of the degenerative-degenerative character in the joints of patients with injections of preparations containing hyaluronate, began with the 70-ies of the last century. The drug was called Hyaluronic acid.

For the treatment of joints affected by deforming arthrosis, it suited at the right time, because was a safe alternative to the operating method and markedly improved the quality of life patients.

The most common drugs in pharmacies today are Ostenil (including Ostenil Mini and Ostenil Plus), as well as Sinocrom and "Fortress Synocrome" - from Germany and Austria, "Fermatron" (Fermatron C and "Fermatron Plus") - from Great Britain, "Suplazin" - from Ireland. More rarely you can find such popular drugs as Adant (Japan), ViskoPlus (Sweden), Viskosil (Germany), "Gialgan Fidia" (Italy), "Hyalual Artro" (Ukraine), "Hyalux" and "Giruan Plus" (South Korea), "Diuralan Es Jay" and Synvisc (USA). Of the domestic drugs are allocated "Hyastat" (Tula) and "Intraject Gialuform" (laboratory "Toscani" Moscow). Drugs for replacing the joint fluid, which contain sodium hyaluronate, are solutions that are manufactured in disposable syringes.

The cost of drugs with hyaluronic acid for joints

Most of the above drugs can be purchased at pharmacies. However, judging by the reviews, hyaluronic acid for joints (especially foreign production) - a pleasure not cheap.

The price varies from three to five thousand rubles per syringe. A considerable share in this amount is known brand. The cost of Russian drugs in this category is lower by about a third.

In addition, the procedure will have to pay an average of 500-1000 rubles (shoulder and knee joints), and for problems with the hip - up to 1500 rubles. So, for example, one intra-articular injection with the preparation "Hyalux" is offered for 4750 rubles.

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If you consider that such pricks for the course should be done from three to five (depending on the condition of the joints), then the total amount can greatly facilitate the patient's personal or family budget.

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However, an alternative to such treatment is an expensive and unsafe operation for joint replacement, so many people prefer the timely use of drugs with hyaluronate.

Hyaluronic acid: reviews

For joints, liquid implants in the form of a hydrogel with hyaluronidase bring a significant benefit. Therefore, all opinions and comments from both rheumatologists and ordinary patients on the network are extremely positive.

Many of them advise not to save on the quality of drugs, because it depends not only on the outcome of the procedure, but also on the health of the joints. Foreign drugs are praised for instant effect.

Hyaluronic acid for the knee joint is administered intra-articularly once a week on an outpatient basis. The majority of patients testify to the appearance of a small swelling after the injection, thanks to the introduced volume of hyaluronic acid.

Within a day or two, the appearance of the joint acquires a habitual form.

Tip

In addition to the quality of the drug, interlocutors at the forums recommend paying attention to the doctor's qualification and the reputation of the clinic.

After therapy with the drug with hyaluronic acid, in their opinion, prolonged relief of the condition is felt.

A full active life with walks, favorite sports and travels again becomes available!

A source: http://.ru/article/219854/gialuronovaya-kislota-dlya-sustavov-preparatyi-i-otzyivyi-o-nih

Hyaluronic acid preparations for joints and all the details

Hyaluronic acid was discovered in the 1930s by Carl Meyer. This chemical element, as it turned out, is present in the body of many animals, including humans. The main habitats are skin and joints.

Hyaluronic acid for human jointsindispensable, so its analogues are widely used for arthrosis and other diseases associated with these parts of the body.

Why are preparations based on this acid necessary for joints?

Joints - one of the most complex mechanisms in the human body. At the point of convergence of the bones, the ends of each of them are covered with cartilage, and between the cartilages there is a synovial fluid.

This fluid nourishes the cartilage (they do not have their blood vessels) and acts as a kind of lubricant between them.

As soon as the synovial fluid is not enough - the cartilage ceases to receive the proper nutrition and begin to become inflamed, and in neglected cases it rubs against each other.

Hyaluronic acid -the main component of the synovial fluid. It is responsible for the viscosity. Diseases of the joints are most often associated with a lack of synovial fluid, and replenishing the amount of acid is beneficial to the joint and, consequently, to the patient.

How does it work?

Getting acid from animal tissues is problematic, so now the pharmaceutical companies get synthetic hyaluronic acid, which is similar in chemical composition to natural. An alternative is to get acid from bacteria (Streptococcus).

The acid thus obtained is injected directly into the joint. This procedure is called "liquid prosthetics because in fact, the injection is a prosthesis of the synovial fluid.

In addition, the lubricity of the synovial fluid increases, which allows the joint to move more freely and prevents mechanical damage within the ligament.

Watch a video to learn more about this.

Indications for use

Hyaluronic acid can be used in the following cases:

• with arthrosis of the shoulder, elbow, hip and other joints;
• rehabilitation after trauma;
• the risk of mechanical damage to the cartilage;
• pain syndrome;
• period after the diagnostic penetration into the joint cavity.

Also, the acid can be prescribed for supporting and prophylactic purposes:

• if additional cartilage is needed;
• to accelerate regeneration;
• with inflammation;
• to increase the viscosity of the synovial fluid.

The most frequent appointment of a doctor is hyaluronic acid in the knee joint.

Contraindications

Contraindications for the use of hyaluronic acid are:

• an allergic reaction to the components of the drug;
• age to 18 years;
• pregnancy or lactation;
• presence of an infectious disease;
• Wounds, skin diseases at the injection site.

Side effects

Side effects are few:

• increased fever, burning, itching (allergic reactions);
• edema at the injection site;
• hemorrhage in the joint;
• hematoma around the injection site.

When allergic reactions occuryou must immediately cancel the drugto prevent more serious consequences (anaphylactic shock, angioedema). The remaining cases are the reaction of the body to an invasion or a careless procedure, and you can restrict yourself to applying a cold compress to the site of the injection.

Forms of release

The drug can be used in three ways:orally, locally, in the form of injections. Each of the ways should be discussed separately.

For oral use, hyaluronic acid is produced in tablets and capsules. Doctors note the questionable effectiveness of this method, as it is distributed throughout the body, and the affected joint gets an insignificant part.

Such drugs are classified as dietary supplements. The effect of using a tablet or capsule is comparable to several portions of food rich in this acid.

Therefore, they can drink only to keep the level of hyaluronic acid normal throughout the body, other options should be considered for the therapeutic effect.

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For local use, there are ointments and gels. For joints, they are also ineffective, since the main part does not fall into the joint and remains in the skin. On the other hand, hyaluronic acid rejuvenates the skin and saturates it with moisture, so the ointment or gel will be effective for cosmetic purposes.

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To hit the acid in the bowels of the body use fillers and injections. Filler is a subcutaneous microinjection. Used in cosmetology to improve the quality of the skin and smooth wrinkles.

The usual injectionis the only way to cure the joint, since the necessary chemical element is delivered directly to the destination.

List of drugs, form of release and prices

Hyaluronic acid preparations for joints are supplied to the market by different countries and under different names.

Russia

• Hyastat is an opalescent hydroalgel of hyaluronic acid in hermetic and sterile syringes (20 mg). Shelf life - 2 years. The price is 2300 rubles.
• Hyalurum CS includes a solution of sodium hyaluronate 60 mg / 3 ml and a solution of chondroitin sulfate 90 mg / 3 ml in syringes of 3 ml. Chondroitin sulfate stimulates the regeneration of tissues, retains water and restores the damping function. Together with hyaluronic acid it has an effective healing effect on the damaged joint. The price is 7700 rubles.
• RusVisk consists of a physiological solution of sodium hyaluronate of non-animal origin. Intended for intraarticular administration. The price is 4680 rubles.
• Hyaluron Chondro is a solution for intra-articular injection, prefilled in 2 ml syringes. The cost is 5090 rubles.

Germany and Austria

• Viskosil - solution for the introduction of the inside of the joint, contains sodium hyaluronate, sodium chloride, sodium hydrogen hydrogen phosphate, sodium dihydrogen phosphate, water for injection. The volume of the syringe is 1 ml. The price is 2500 rubles.
• Ostenil mini is used for osteoarthritis of small joints. Developed by the German-Swiss company TRB CHEMEDICA. It is inserted inside the joint. Retail price - 2163 rubles.
• Forte Syncope - 2% aqueous solution of sodium hyaluronate from the Austrian company Kroma Pharma GmbH. The price is about 2600 rubles.

USA

• Duralan Es Jay is an expensive drug for the treatment of joints based on hyaluronic acid. The price of the injection is up to 1, 00 rubles.
• Sinswisk is an analogue of the previous medicine with a price of 2, 00 rubles.
• Solgar - tablets, which, according to the creators, can fight sick joints. For 30 tablets of 120 mg of active substance in each have to pay a little more than 1000 rubles.

Great Britain and Ireland

• Suplazin - intraarticular injection, improves working capacity and normalizes the joint after arthrotcentesis. The price is 2900 rubles.
• Fermatron - pure solution of sodium hyaluronate 1%. The average price is 4000 rubles.
• Fermatron plus - a sterile solution of sodium hyaluronate, which is dissolved in a phosphate buffer medium. The price is slightly less than 6000 rubles.

Italy

• Gou-on is a solution for injections, the syringe contains, ml. Includes: sodium hyaluronan, sodium chloride, sodium dihydrogen phosphate, water for injection. The price is 2100 rubles.
• Hualubriks - hyaluronic acid in a 2 ml syringe. The average price is 1, 00 rubles.
• Gialgan Phidia is an analog of Hialurbriks, only twice cheaper. The price is about 5500 rubles.

Sweden

• Versan Fluid is not the most expensive Swedish injection. The price is 6300 rubles.
• ViskoPlyus is an injection of an average price category. The price is about 6600 rubles.
• Restylane vital - an injection of 1 mg. It is used mainly for subcutaneous cosmetic injections. The price is 1, 00 rubles.

Ukraine

• The only representative is Hyalual Artro. Injections have a price of 5150 rubles.

Japan

• Adant is a solution for injection in a syringe. The price is 5100 rubles.
• KWC - injections for all types of connective tissue, 4150 rubles.

South Korea

• Atri Ing - one 2.5 mg syringe filled with sodium hyaluronate. The price is 3673 rubles.
• Giruan plus plus sodium hyaluronate contains sodium chloride, which helps the acid to be absorbed. One syringe will cost 5000 rubles.
• Hyalux is pure acid, 4300 rubles.

The cheapest drugs are RussianHyastat(2300 rubles) and ItalianGo-on(2100 rubles).

Criteria for drug selection

Hyaluronic acid by its formula is the same, but the quality of production can be different, so it is worth paying attention not only to the volume and additional components, but also to the reviews. Some drugs contain sodium chloride, which helps the acid to digest, some contain other medicinal components.

The surest way to not get lost in names and chemical terms is to consult a doctor.

Use of injections

Intraarticular injections of hyaluronic acid can not be stabbed alone.

If there are indications, the doctor prescribes a course of treatment - usually 3-5 injections, 1 injection per week.

The procedure is performed under local anesthesia or without it (for the knee joint and other accessible places).

The doctor penetrates the needle into the joint cavity and injects the medicine. After this, the patient needs rest.

Intra-articular administration of hyaluronic acid is performed in conditions of complete sterility, so as not to infect the joint.

The procedure on the hip joint is performed under X-ray control, since this joint is hidden deep under the muscles.

The course can be repeated in 6-12 months.

Products containing hyaluronic acid

Since the body itself does not reproduce the stores of acid, its main source is food.

In the first place are the cartilage by-products and stew with cartilage. Chilled meat and broth is an excellent choice for those who want to make up for the lack of this chemical element.

The second place is occupied by legumes: soybeans, beans, peas.

The third is cereals and some vegetables with a lot of starch: lentils, potatoes, buckwheat, beets, squash, rice, radish, corn.

It is worth knowing that a plate of cold, a portion of boiled rice and a good piece of stew does not replace injections in the knee joint, but replace the daily course of tablets with hyaluron.

Reviews

Doctors agree that the tool works effectively for problems with joints. The most common purpose is injections into the knee joint.

Doctors say that different companies provide different quality medicines, and there is practically no information on this issue.

Some medicines give a significant effect after 3 days of intake, some remain at an average level of efficacy through 5.

As a result, each doctor forms his opinion about this or that trade mark.

Patients remain satisfied with the course of treatment. A positive effect is achieved if not in all, in the overwhelming majority of cases. From the nuances: after the injection, there is often a swelling, the level of the injection's comfort largely depends on the skill and experience of the doctor.

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Naturally, no patient was satisfied with the cost of treatment. But, according to one patient: "When it is strongly squeezed and nothing helps, the price goes to the background."

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Hyaluronic acid isa chemical compound that directly affects the condition of the skin and joints. At its or her lack the last start to wear out, inflame and hurt or be ill; be sick.

With such symptoms, the only way to return the joints to a normal state is by injecting hyaluronic acid or its analog directly into the joint. Tablets and ointments are ineffective.

The injection should be performed by a doctor under sterile conditions.

The course is from 3 to 5 days and almost always brings the joint back to normal.How to forget about joint and spinal pain?

• Does pain limit your movements and full life?
• Are you worried about discomfort, crunching and systematic pain?
• Perhaps you have tried a bunch of medicines, creams and ointments?

A source: http://zdorovya-spine.ru/preparaty-i-lekarstva/gialuron-spisok.html

Hyaluronic acid for joints: contraindications, indications, therapeutic effect, pluses, minuses

Hyaluronic acid, hyaluronate (hereinafter - HA) is a unique chemical compound, actively used in medicine for the treatment of a number of diseases and cosmetology for the correction of appearance. It was opened in the 1930s. Carl Meyer. In the US, the CC is approved by the FDA - a special department that monitors food and medicine.

Has a wide range of applications - treatment of osteoarthritis, cancer therapy, eye surgery, tissue engineering, cosmetology. The substance can be injected into the capsule of the joints, subcutaneously, applied topically and taken internally.

Are hyaluronic acid preparations for joints "liquid endoprostheses" and are able to repair the cartilaginous shells of the bone heads that form the articulation? Unquestionable is only one - hyaluronate is produced by the human body, is present in many tissues and body fluids (about 15 g. in a person weighing 70 kg) and performs vital functions.

The role of GC in joints

Endogenous GK is produced by fibroblast cells.

This is a natural polysaccharide from the glycosaminoglycan family, consisting of two sugars: glucuronic acid and N-acetyl-glucosamine.

It is present in cartilage and synovial fluid, it can include 2, 00 linear monomers of disaccharide, the average molecular weight is 2000 kD.

HA is responsible for the elasticity of the synovial fluid in the joints. The higher the fluid's elasticity, the greater the molecular weight of hyaluronates.

It turns out that with slow movements in the joint hyaluronates are a lubricant, and with rapid movements - a shock absorber.

• With age, the total acid content in the body increases, but at the same time its molecular weight decreases, and the functions assigned to this compound also suffer.
• It is proved that the size of HA molecules decreases in inflammatory processes in the joint (acute and chronic).
• In patients with osteoarthritis, the concentration of HA in the synovial fluid is lower than in healthy people.

Mechanism of action of hyaluronates in synovial fluid and application for the treatment of joints

Exogenous hyaluronic acid for joints has been used for a long time and is called the prosthesis synovial fluid.

Hyaluronates are the "substitutes" of the synovial fluid, they allow the articular and periarticular pain syndrome to be cured and are highly effective in the complex treatment of osteoarthritis.

Being the main element of the synovial fluid, the acid is responsible for its viscosity, provides a lubricating effect and absorbs shock impulses. It is also included in the articular cartilage, or more precisely - in the shell of chondroitocytes.

In the interaction of acid molecules with aggrekan monomers, which occurs in the presence of protein, large, water-absorbing negatively charged aggregates are formed in the cartilaginous tissue.

These compounds are responsible for the elasticity of the cartilage, i. E. its resistance to external influences.

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Maintaining the optimal level of HA in the synovial fluid prevents the loss of proteoglycans by the matrix and stops the invasion of activated macrophages into the joint cavity.

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Hyaluronates inhibit the phagocytic function of cells and inhibit the release of inflammatory mediators, inhibit the dehydration of cartilage, and stimulate the synthesis of new cells.

Scientific research and facts

Practically every patient with osteoarthritis is offered joint injections using hyaluronate preparations, and many agree.

The price of drugs is high, but they are appointed by a short course, which, together with the predicted positive effects, tilts the scales to their choice.

What really?

In all patients with osteoarthritis in the synovial fluid, the average molecular weight and concentration of hyaluronates are reduced. This served as a rationale for the use of pricks in the joint with arthrosis, but the question arose, drugs with what molecular mass will be more effective.

The duration of action of the drugs does not correlate with their basic mechanical role in the joint, since the positive effect is retained on several months after the injection, while the period of excretion of hyaluronic acid from the joint capsule is from 2 hours to 10 days. The observed difference between the period of finding the drug in the joint bag and the duration of the clinical effect can be is associated with increased penetration of medium-molecular hyaluronates into the extracellular matrix of synovial tissues, and possibly in cartilage. In experimental animal studies, evidence was obtained that hyaluronates with an average molecular weight were more effective penetrate into the joint tissues, and it is pathological changes in synovial tissues that provide increased accessibility for molecules gualuronate.

But these issues are still being discussed.

Today, it is universally accepted that hyaluronates with a molecular weight equal to normal that are observed in healthy people in the synovial fluid (and this is about 2000 kDa) provide optimal elastic properties of intraarticular fluid and good mechanical protection of the joint cartilage. But according to reviews, a good complex effect is also possessed by drugs with low and high molecular weight.

At the moment there is an impressive list of drugs-hyaluronates, which differ among themselves in production technology, indicators of molecular weight, additional components, the producing country and, of course, the price, which in any case is high.

Medicines for joints in ampoules or immediately in sterile syringes are released for direct introduction into the joint.

Injections are performed only by a doctor in a hospital, in the department of rheumatology, under the supervision of ultrasound - in all other cases, the risk of infection in the joint cavity is very high!

Preparations are made using two main technologies: from animal tissues (crests of sexually mature cocks, chickens, umbilical cord animals) and bacterial fermentation: a number of Streptococcus and Pasteurella strains form a HA-containing shell.

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Bacterial preparations make up the bulk of the market, but most of them are synthesized by bacteria that are pathogenic to humans, therefore from the point of view of toxicology, hyaluronic acid injections synthesized from animal tissues are preferable, but only highly purified.

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The main allergens in the composition of the preparations are impurities of proteins.

The degree of immunogenicity of protein fractions may be higher in preparations obtained by the bacterial fermentation method, although their concentration in the preparation itself may be lower.

This is due to the pathogenicity of bacteria involved in the bacterial fermentation reaction for humans. In addition to proteins, allergens can be impurities of DNA and RNA bacteria.

The effectiveness of intra-articular therapy of HA is proven in osteoarthritis of the shoulder, knee, clavic-acromial, ankle, hip, temporomandibular joints, as well as small articulations of the hand and wrist.

When administered orally, HA is distributed throughout the body, and when applied locally, the degree The absorption of the substance by the tissues is small, and all the acid that entered the body remains in the body. skin.

Comparative characteristics of drugs intended for injection into the joint

The spectrum of these drugs is constantly expanding: new medicines are being manufactured, many of them are registered in the territory of the Russian Federation and occupy their niche in the pharmaceutical market. The data presented are indicative, and patients should first of all rely on the recommendations of the attending physician.

Name of group of drugs	Trade names of preparations	Characteristic
Low molecular weight preparations	Suplazin, Gialgin Fidia, Fermatron	They are well tolerated and are characterized by rapid cleavage of the introduced HA in the joint, but with a short duration of positive action. They are also used for extraarticular injections in tendinitis, tenosynovitis, bursitis. It is enough 3-5 injections per course.
Preparations with an average molecular weight	Intragel, Ortholur, Viskosil, Girujan Plus, Hyastat, Rusvisc, Hyalual Artro, ViskoPlyus, Synocrome Forte	The largest group of drugs that are products of bacterial fermentation. Not bad are transferred in most cases and are introduced 3-5 times during the course. Some of them can be administered immediately after arthroscopic intervention in order to normalize the metabolism.
High molecular weight preparations	Synwisk	They have the longest analgesic effect, which can be explained by the long period of removal of HA from the joint.
Preparations with the presence of cross molecules	Diuralan Es Jay	They have a pronounced analgesic effect and significantly improve the damping properties of the synovial fluid. It may take just one injection.
Drugs with active concomitant components	Ostenil Plus	In addition to the main, they have pronounced additional effects, for example, anti-inflammatory, dehydrating.

Hyaluronic acid in the knee joint

The positive clinical effect of intraarticular treatment of HA with gonarthrosis has been demonstrated in controlled studies. After 6 months. pricks with arthrosis of the knee joint patients noted a reduction in pain.

The clinical efficacy of CG jabs correlated with the severity of structural disorders in osteoarthritis of the knee joints: the highest was in patients with the lowest severity of the disease, low - in the presence of articular effusion.

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Assessment of the arthroscopic pattern of the knee joint before treatment and after 1 year of therapy allowed to confirm a low degree of structural damage in the cartilage of the joint compared with patients who did not receive GK.

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Also, treated patients noted a decrease in the need for non-steroidal anti-inflammatory and corticosteroid preparations that have much more serious side effects than hyaluronates, increased the quality of life.

Side effects and drawbacks of drugs

According to the results of long-term observations, side effects are rare. There may be the following local reactions (at the site of administration):

• sensation of heat;
• itching and burning;
• swelling;
• redness of the skin.

Patients can note rapid-passing pain in nearby muscles. To side effects quickly passed, sometimes it is enough to apply a cold compress to the joint.

It is extremely rare in patients (described only a few cases) develops a severe acute inflammatory reaction or pseudoepsis at the site of the injection.

If, after the injection, general hypersensitivity phenomena develop (swelling of the mucous membranes of the mouth and larynx, urticaria, paresthesia), you should immediately consult a doctor and cancel the drug, because it is possible to develop anaphylactic reaction. Although the systemic side effects were not observed in patients during the entire period of application of the drugs of this group.

Unfortunately, not all patients have clinical improvement, and in some cases, the symptoms may worsen. It turns out that expensive drugs can bring harm.

The effectiveness of treatment depends on the individual reaction of the organism, the stage of the disease (at terminal stages of expediency in such treatment is not present), and also from qualification of the medical worker conducting injection.

Contraindications for use

Hyaluronic acid preparations have a number of strict contraindications that can not be ignored:

• hypersensitivity to the active or additional components of drugs;
• acute inflammation inside the joint;
• children's age till 18 years;
• the period of breastfeeding;
• pregnancy;
• skin integrity disorder or dermatological diseases at the injection site;
• acute period of infectious diseases;
• hyperthermia.

Conclusions:HA preparations with intra-articular injection have an anti-inflammatory, analgesic and structural-modifying effect lasting up to 8-12 months.

after a course of injections, allow to postpone the time of endoprosthetics and help patients who are contraindicated this surgical method of treatment (diabetes mellitus, early recovery period after a stroke and heart attack and etc).

They play an important role in the complex treatment of OA.

According to experts, hyaluronates and corticosteroids have approximately equal efficacy after 1 month after injection, but 5-13 weeks after the administration of HA preparations show a significantly greater Effect.

A source: http://zdravotvet.ru/gialuronovaya-kislota-dlya-sustavov-protivopokazaniya-pokazaniya-lechebnyj-effekt-plyusy-minusy/