Selection of hyaluronic acid for intra-articular administration in severe pain

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Abstract

This article examines current understanding of the pathogenesis of osteoarthritis and the mechanisms underlying pain syndrome development under conditions of mechanical joint overload, inflammation, and progression of degenerative changes. The mechanisms of action of hyaluronic acid, which provide mechanical joint relief and have anti-inflammatory, chondroprotective, and analgesic effects, are analyzed. Clinical trial data and international guidelines confirming the efficacy and safety of intra-articular hyaluronic acid administration for osteoarthritis in various locations are presented. The importance of the physicochemical characteristics of hyaluronic acid, which determine its rheological properties, duration of action, and clinical efficacy, is examined.

A comparative analysis of the high-molecular intra-articular implants Flexotron® Plus and Flexotron® Magnum is conducted. It is shown that the products differ in sodium hyaluronate concentrations, which may determine the specifics of their clinical use. Flexotron® Plus may be a rational choice for patients with severe pain and functional impairment, while Flexotron® Magnum may be of greater interest for patients with pain associated with chondromalacia and articular cartilage damage, requiring more significant mechanical joint support.

About the authors

Olga A. Mubarakshina

Voronezh State Medical University named after N.N. Burdenko

Author for correspondence.
Email: mubarakshina@mail.ru
ORCID iD: 0000-0001-6799-6322

Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology

Russian Federation, Voronezh

Yulia M. Dronova

Voronezh State Medical University named after N.N. Burdenko

Email: y.dronova@yandex.ru
ORCID iD: 0000-0003-4513-091X

Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology

Russian Federation, Voronezh

Olga A. Zhdanova

Voronezh State Medical University named after N.N. Burdenko

Email: olga.vr9@yandex.ru
ORCID iD: 0000-0002-3917-0395

Dr. Sci. (Med.), Associate Professor, Professor at the Department of Clinical Pharmacology

Russian Federation, Voronezh

Galina A. Batishcheva

Voronezh State Medical University named after N.N. Burdenko

Email: bat13@mail.ru
ORCID iD: 0000-0003-4771-7466

Dr. Sci. (Med.), Professor, Head of the Department of Clinical Pharmacology

Russian Federation, Voronezh

Dmitry V. Peshekhonov

XXI Century Clinic, Voronezh

Email: dmmad@yandex.ru
ORCID iD: 0009-0003-2522-7586

Dr. Sci. (Med.), Rheumatologist

Russian Federation, Voronezh

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