Can Combining Hyaluronic Acid and Physiotherapy in Knee Osteoarthritis Improve the Physicochemical Properties of Synovial Fluid?
Ilie Onu,
Robert Gherghel,
Isabella Nacu,
Florina-Daniela Cojocaru,
Liliana Verestiuc,
Daniela-Viorelia Matei,
Dan Cascaval,
Ionela Lacramioara Serban,
Daniel Andrei Iordan,
Alexandra Tucaliuc,
Anca-Irina Galaction
Affiliations
Ilie Onu
Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700454 Iasi, Romania
Robert Gherghel
Department of Physiotherapy, Micromedica Clinic, 610119 Piatra Neamt, Romania
Isabella Nacu
Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700454 Iasi, Romania
Florina-Daniela Cojocaru
Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700454 Iasi, Romania
Liliana Verestiuc
Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700454 Iasi, Romania
Daniela-Viorelia Matei
Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700454 Iasi, Romania
Dan Cascaval
Department of Organic, Biochemical and Food Engineering, Faculty of Chemical Engineering and Environmental Protection “Cristofor Simionescu”, Technical University “Gheorghe Asachi”, 700050 Iasi, Romania
Ionela Lacramioara Serban
Department of Morpho-Functional Sciences II, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
Daniel Andrei Iordan
Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
Alexandra Tucaliuc
Department of Organic, Biochemical and Food Engineering, Faculty of Chemical Engineering and Environmental Protection “Cristofor Simionescu”, Technical University “Gheorghe Asachi”, 700050 Iasi, Romania
Anca-Irina Galaction
Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700454 Iasi, Romania
Known as the degenerative disease of the knee with the highest prevalence, knee osteoarthritis (KOA) is characterized by a gradual destructive mechanism that, in severe cases, can provoke the need for total knee substitution. As the disease progresses, various enzymatic, immunological, and inflammatory processes abnormally degrade hyaluronic acid (HA), SF’s main component, and affect the concentrations of specific proteins, with the final results seriously endangering synovial fluid (SF)’s rheological and tribological features and characteristics. No effective treatments have been found to stop the progression of KOA, but the injection of HA-based viscoelastic gels has been considered (alone or combined with physiotherapy (PT)) as an alternative to symptomatic therapies. In order to evaluate the effect of viscosupplementation and PT on the characteristics of SF, SF aspirated from groups treated for KOA (HA Kombihylan® and groups that received Kombihylan® and complex PT) was analyzed and compared from analytical, spectrophotometrical, and rheological perspectives. In the patients treated with PT, the SF extracted 6 weeks after viscosupplementation had a superior elastic modulus (G′) and viscous moduli (G″), as well as a homogeneous distribution of proteins and polysaccharides. The viscosupplementation fluid improved the bioadhesive properties of the SF, and the use of the viscosupplementation fluid in conjunction with PT was found to be favorable for the distribution of macromolecules and phospholipids, contributing to the lubrication process and the treatment of OA-affected joints.
