Delaying surgery for knee osteoarthritis: efficacy and benefits of using cross-linked sodium hyaluronate. A review

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Abstract

The prevalence of knee osteoarthritis (OA), which has been steadily increasing in recent decades, represents a serious clinical and economic problem. This situation necessitates an active search for effective conservative treatment methods capable of slowing disease progression and delaying the need for total knee arthroplasty (TKA). This article presents a detailed analysis of the current role of intra-articular administration of hyaluronic acid (HA) preparations in OA therapy. The necessity of personalized treatment approach based on OA phenotyping is justified, and consensus recommendations from the European expert group EUROVISCO are provided, defining specific clinical situations for rational use of HA. Special attention is given to cross-linked HA drugs that, due to their prolonged residence time in the joint, provide both long-lasting mechanical (shock absorption) and delayed biological (viscoinduction) effects. Advantages of the innovative CHAP technology implemented in Flexotron Cross® drug are discussed, allowing achieving faster and more pronounced analgesic effect compared to other cross-links. Data demonstrating the impact of course application of HA on significantly postponing TKA timelines are presented, providing patients with opportunities for lifestyle modification, particularly weight loss, which substantially reduces perioperative risks. Additionally, the issue of contralateral joint OA progression after unilateral TKA is addressed, discussing protective role of HA in preventing its damage by reducing pain and normalizing movement patterns.

About the authors

Olga V. Teplyakova

Ural State Medical University; Medical Association «New Hospital»

Author for correspondence.
Email: oteplyakova69@gmail.com
ORCID iD: 0000-0003-2114-0419
SPIN-code: 3208-8679

D. Sci. (Med.)

Russian Federation, Ekaterinburg; Ekaterinburg

Andrey V. Zhilyakov

Ural State Medical University

Email: oteplyakova69@gmail.com
ORCID iD: 0000-0003-1261-3712

D. Sci. (Med.)

Russian Federation, Ekaterinburg

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