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Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme ve Klinik Kullanımlarının Değerlendirmesi

Yıl 2024, Cilt: 50 Sayı: 1, 113 - 119, 17.05.2024

Umut Doğu Seçkin Özgün Selim Germiyan Yiğit Uyanıkgil

https://doi.org/10.32708/uutfd.1398661

Öz

Osteoartrit (OA), dünya genelinde yetişkinlerde yaygın olarak görülen kronik bir eklem hastalığıdır ve ağrı, hareket kısıtlılığı ve yaşam kalitesinde düşüşle karakterize edilir. OA'nın patofizyolojisi, eklem kıkırdağının aşınması ve altındaki kemikteki değişikliklerle ilgilidir, bu da eklem fonksiyonunun bozulmasına ve ağrıya yol açar. Günümüzde OA tedavisinde, semptomatik rahatlama sağlamak ve eklem fonksiyonunu iyileştirmek için çeşitli yöntemler kullanılmaktadır. Bunlar arasında farmakolojik olmayan yaklaşımlar, analjezikler, non steroidal anti-inflamatuar ilaçlar (NSAİİ) ve eklem içi enjeksiyonlar bulunur. Eklem içi hyaluronik asit (HA) enjeksiyonları, özellikle ilaç tedavisine yanıt vermeyen veya cerrahi müdahale için uygun olmayan OA hastalarında popüler bir tedavi seçeneğidir. HA enjeksiyonlarının etkinliği ve güvenliği üzerine yapılan çalışmalar çeşitli sonuçlar ortaya koymuştur. Bazı klinik çalışmalar, HA enjeksiyonlarının OA semptomlarını hafifletmede etkili olduğunu ve eklem fonksiyonunu iyileştirdiğini göstermektedir. Bu çalışmalar, HA'nın eklemlerdeki ağrıyı azalttığını ve hareket kabiliyetini artırdığını belirtmektedir. Eklem içi HA enjeksiyonlarının klinik kullanımı, hastanın genel sağlık durumu, OA'nın şiddeti ve diğer tedavi yöntemlerine yanıtı gibi faktörlere bağlı olarak değişkenlik gösterir. Bu bağlamda, eklem içi HA enjeksiyonlarının OA tedavisindeki rolünü değerlendiren sistematik bir gözden geçirme, mevcut bilimsel kanıtları, tedavinin etkinliğini ve güvenliğini objektif bir şekilde değerlendirmeye olanak tanır. Ayrıca, bu gözden geçirme, farklı hasta grupları üzerindeki etkileri ve potansiyel riskleri kapsamlı bir şekilde inceleyerek, klinik karar verme sürecine önemli katkılar sağlayabilir. Bu nedenle, eklem içi HA enjeksiyonlarının OA tedavisindeki yeri, halen önemli bir araştırma ve tartışma konusudur. Bu derleme makalede sodyum hyaluronat bazlı jellerin tanımlamaları ve gözden geçirilmesi, güvenlik süreçleri ve klinik kullanımlarının değerlendirilmesi ele alınmıştır.

Anahtar Kelimeler

Osteoartrit Sodyum hiyaluronat Hiyaluronik asit Hidrojel

Kaynakça

  • 1. Man GS, Mologhianu G. Osteoarthritis pathogenesis–a complex process that involves the entire joint. Journal of medicine and life 2014; 7(1), 37.
  • 2. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Annals of the rheumatic diseases 2001;60(2), 91-97.
  • 3. Michael JWP, Schlüter-Brust KU, Eysel, P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Arzteblatt International 2010;107(9),152.
  • 4. Van Der Kraan PM, Van Den Berg WB. Osteophytes: relevance and biology. Osteoarthritis and cartilage 2007; 15.3: 237-244.
  • 5. Bijlsma JWJ, Knahr K. Strategies for the prevention and management of osteoarthritis of the hip and knee. Best practice & resear ch Clinical rheumatology;2007, 21.1: 59-76.
  • 6. Duruöz MT, Öz N, Gürsoy DE, Gezer HH. Clinical aspects and outcomes in osteoarthritis. Best Practice & Research Clinical Rheumatology 2023;101855.
  • 7. Banks SE. Erosive osteoarthritis: a current review of a clinical challenge. Clinical rheumatology, 2010;29, 697-706.
  • 8. Abhishek A, Doherty M. Diagnosis and clinical presentation of osteoarthritis. Rheumatic Disease Clinics 2013; 39.1: 45-66.
  • 9. Brandt KD, Radin EL, Dieppe PA, Van De Putte L. Yet more evidence that osteoarthritis is not a cartilage disease. Annals of the rheumatic diseases 2006; 65(10), 1261-1264.
  • 10. McGonagle D, Tan AL, Grainger AJ, Benjamin M. Heberden's nodes and what Heberden could not see: the pivotal role of ligaments in the pathogenesis of early nodal osteoarthritis and beyond. Rheumatology 2008; 47(9), 1278-1285.
  • 11. Román-Blas JA, Castañeda S, Largo R, Herrero-Beaumont G. Subchondral bone remodelling and osteoarthritis. Arthritis Research & Therapy 2012;14, 1-8.
  • 12. Kloppenburg M, Kwok WY. Hand osteoarthritis—a heterogeneous disorder. Nature Reviews Rheumatology 2012;8(1), 22-31.
  • 13. Vashishtha A, Kumar-Acharya A. An overview of medical imaging techniques for knee osteoarthritis disease. Biomedical and Pharmacology Journa 2021;14(2), 903-919.
  • 14. Marshall KW, Zhang H, Yager TD, Nossova N, Dempsey A, Zheng R, Liew CC. Blood-based biomarkers for detecting mild osteoarthritis in the human knee. Osteoarthritis and cartilage 2005;13(10), 861-871.
  • 15. Neuprez A, Neuprez AH, Kaux JF, Kurth W, Daniel C, Thirion T, Reginster JY. Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years. Clinical rheumatology 2020; 39, 861-871.
  • 16. Mahendira L, Jones C, Papachristos A, Waddell J, Rubin L. Comparative clinical and cost analysis between surgical and non-surgical intervention for knee osteoarthritis. International Orthopaedics 2020; 44, 77-83.
  • 17. Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, Vlieland TPV. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Annals of the rheumatic diseases 2013;72(7), 1125-1135.
  • 18. Da Costa BR, Pereira TV, Saadat P, Rudnicki M, Iskander SM, Bodmer NS, Jüni P. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis. Bmj 2021; 375.
  • 19. Tetteh ES, Bajaj S, Ghodadra NS, Cole BJ. The basic science and surgical treatment options for articular cartilage injuries of the knee. journal of orthopaedic & sports physical therapy 2012; 42(3), 243-253.
  • 20. Madry H, Grün UW, Knutsen G. Cartilage repair and joint preservation: medical and surgical treatment options. Deutsches Ärzteblatt International 2011;108(40), 669.
  • 21. Ahmad SS, Gantenbein B, Evangelopoulos DS, Schär MO, Schwienbacher S, Kohlhof H, Kohl S. Arthroplasty–current strategies for the management of knee osteoarthritis. Swiss medical weekly 2015; 145(0708), w14096-w14096.
  • 22.Postler A, Lützner C, Beyer F, Tille E, Lützner J. Analysis of total knee arthroplasty revision causes. BMC musculoskeletal disorders 2018; 19, 1-6.
  • 23.Alvand A, Miles J, Carrington R. Surgical strategies formanagement of infection following knee arthroplasty andarthroscopic procedures. Orthopaedics and Trauma 2019; 33(3), 166-174.
  • 24.Madry H. Surgical therapy in osteoarthritis. Osteoarthritis andcartilage 2022;30(8), 1019-1034.
  • 25.Fusco G, Gambaro FM, Di Matteo B, Kon E. Injections in the osteoarthritic knee: a review of current treatment options. Efort Open Reviews 2021; 6(6), 501-509.
  • 26.Koenig KM, Ong KL, Lau EC, Vail TP, Berry DJ, Rubash HE,Bozic KJ. The use of hyaluronic acid and corticosteroid injections among Medicare patients with knee osteoarthritis. The Journal of Arthroplasty 2016;31(2), 351-355.
  • 27.Cook SG, Bonassar LJ. Interaction with cartilage increases the viscosity of hyaluronic acid solutions. ACS BiomaterialsScience & Engineering 2020; 6(5), 2787-2795.
  • 28.Saunders S, Longworth S. Injection techniques inmusculoskeletal medicine: a practical manual for clinicians in primary and secondary care. Elsevier Health Sciences; 2018.
  • 29.Adams ME, Lussier AJ, Peyron JG. A risk-benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee. Drug safety 2020; 23, 115-130.
  • 30.Xu X, Jha AK, Harrington DA, Farach-Carson MC, Jia X. Hyaluronic acid-based hydrogels: from a natural polysaccharide to complex networks. Soft matter 2012;8(12), 3280-3294.
  • 31.Necas JBLBP, Bartosikova L, Brauner P, Kolar JJVM.Hyaluronic acid (hyaluronan): a review. Veterinarni medicina 2008; 53(8), 397-411.
  • 32.Boeriu CG, Springer J, Kooy FK, van den Broek LA, Eggink G.Production methods for hyaluronan. International journal ofcarbohydrate chemistry; 2013.
  • 33.Fallacara A, Baldini E, Manfredini S, Vertuani S. Hyaluronic acid in the third millennium. Polymers 2018; 10(7), 701.
  • 34.Fakhari A, Berkland C. Applications and emerging trends ofhyaluronic acid in tissue engineering, as a dermal filler and inosteoarthritis treatment. Acta biomaterialia 2013; 9(7), 7081-7092.
  • 35.Tiwari S, Bahadur P. Modified hyaluronic acid based materials for biomedical applications. International journal of biological macromolecules 2019;121, 556-571.s
  • 36.Juncan AM, Moisă DG, Santini A, Morgovan C, Rus LL,Vonica-Țincu AL, Loghin F. Advantages of hyaluronic acidand its combination with other bioactive ingredients in cosmeceuticals. Molecules 2021; 26(15), 4429.
  • 37.Mantha S, Pillai S, Khayambashi P, Upadhyay A, Zhang Y, Tao O, Tran SD. Smart hydrogels in tissue engineering andregenerative medicine. Materials 2019; 12(20), 3323.
  • 38.Liao Y, He Q, Zhou F, Zhang J, Liang R, Yao X, Ouyang H.Current intelligent injectable hydrogels for in situ articular cartilage regeneration. Polymer Reviews 2020; 60(2), 203-225.
  • 39.López Ruiz E, Jiménez G, Álvarez Cienfuegos Rodríguez L,Antich Acedo C, Sabata R, Marchal Corrales JA, GálvezMartín P. Advances of hyaluronic acid in stem cell therapy and tissue engineering, including current clinical trials; 2019.
  • 40.Fakhari A, Berkland C. Applications and emerging trends of hyaluronic acid in tissue engineering, as a dermal filler and in osteoarthritis treatment. Acta biomaterialia 2013; 9(7), 7081-7092.
  • 41.Lin X, Tsao CT, Kyomoto M, Zhang M. Injectable natural polymer hydrogels for treatment of knee osteoarthritis. Advanced healthcare materials 2022; 11(9), 2101479.
  • 42.Chen W, Li Z, Wang Z, Gao H, Ding J, He Z. Intraarticular injection of infliximab-loaded thermosensitive hydrogelalleviates pain and protects cartilage in rheumatoid arthritis. Journal of pain research 2020; 3315-3329.
  • 43.Cook SG, Bonassar LJ. Interaction with cartilage increases the viscosity of hyaluronic acid solutions. ACS BiomaterialsScience & Engineering 2020; 6(5), 2787-2795.
  • 44.Aggarwal A, Sempowski IP. Hyaluronic acid injections forknee osteoarthritis. Systematic review of the literature. Canadian Family Physician 2004; 50(2), 249-256.
  • 45.Bruno MC, Cristiano MC, Celia C, d’Avanzo N, Mancuso A, Paolino D, Fresta M. Injectable drug delivery systems forosteoarthritis and rheumatoid arthritis. ACS nano 2022;16(12), 19665-19690.
  • 46.Mou D, Yu Q, Zhang J, Zhou J, Li X, Zhuang W, Yang X.Intra-articular injection of chitosan-based supramolecular hydrogel for osteoarthritis treatment. Tissue Engineering and Regenerative Medicine 2021; 18, 113-125.
  • 47.Kim YS, Guilak F. Engineering hyaluronic acid for the development of new treatment strategies for osteoarthritis. International journal of molecular sciences 2022;23(15), 8662.
  • 48.Adams ME, Lussier AJ, Peyron JG. A risk-benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee. Drug safety 2020; 23, 115-130.
  • 49.Vincent HK, Montero C, Conrad BP, Horodyski M, Connelly J,Martenson M, Vincent KR. “Functional pain,” functional outcomes, and quality of life after hyaluronic acid intra-articular injection for knee osteoarthritis. PM&R 2013; 5(4), 310-318.
  • 50.Rwei SP, Chen SW, Mao CF, Fang HW. Viscoelasticity and wearability of hyaluronate solutions. Biochemical engineering journal 2008; 40(2), 211-217.

Safety of Intra-articular Hyaluronic Acid Injections in Osteoarthritis: A Systematic Review and Evaluation of Their Clinical Uses

Yıl 2024, Cilt: 50 Sayı: 1, 113 - 119, 17.05.2024

Umut Doğu Seçkin Özgün Selim Germiyan Yiğit Uyanıkgil

https://doi.org/10.32708/uutfd.1398661

Öz

Osteoarthritis (OA) is a chronic joint disease common in adults worldwide and is characterized by pain, limitation of movement, and decreased quality of life. The pathophysiology of OA relates to wear of articular cartilage and changes to the underlying bone, leading to impaired joint function and pain. Today, various methods are used in the treatment of OA to provide symptomatic relief and improve joint function. These include non-pharmacological approaches, analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), and intra-articular injections. Intra-articular hyaluronic acid (HA) injections are a popular treatment option, especially in OA patients who do not respond to drug therapy or are unsuitable for surgery. Studies on the effectiveness and safety of HA injections have revealed varying results. Some clinical studies show that HA injections are effective in relieving OA symptoms and improving joint function. These studies indicate that HA reduces pain in joints and increases mobility. Clinical use of intra-articular HA injections varies depending on factors such as the patient's general health status, severity of OA, and response to other treatment modalities. In this context, a systematic review evaluating the role of intra-articular HA injections in the treatment of OA allows to objectively evaluate the available scientific evidence, the effectiveness and safety of the treatment. Additionally, this review can provide important contributions to clinical decision-making by comprehensively examining the effects and potential risks on different patient groups. Therefore, the place of intra-articular HA injections in the treatment of OA is still an important subject of research and debate. In this review article, the definition and review of sodium hyaluronate-based gels, their safety processes and evaluation of their clinical use are discussed.

Anahtar Kelimeler

Osteoarthritis Sodium hyaluronate Hyaluronic acid Hydrogel

Kaynakça

  • 1. Man GS, Mologhianu G. Osteoarthritis pathogenesis–a complex process that involves the entire joint. Journal of medicine and life 2014; 7(1), 37.
  • 2. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Annals of the rheumatic diseases 2001;60(2), 91-97.
  • 3. Michael JWP, Schlüter-Brust KU, Eysel, P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Arzteblatt International 2010;107(9),152.
  • 4. Van Der Kraan PM, Van Den Berg WB. Osteophytes: relevance and biology. Osteoarthritis and cartilage 2007; 15.3: 237-244.
  • 5. Bijlsma JWJ, Knahr K. Strategies for the prevention and management of osteoarthritis of the hip and knee. Best practice & resear ch Clinical rheumatology;2007, 21.1: 59-76.
  • 6. Duruöz MT, Öz N, Gürsoy DE, Gezer HH. Clinical aspects and outcomes in osteoarthritis. Best Practice & Research Clinical Rheumatology 2023;101855.
  • 7. Banks SE. Erosive osteoarthritis: a current review of a clinical challenge. Clinical rheumatology, 2010;29, 697-706.
  • 8. Abhishek A, Doherty M. Diagnosis and clinical presentation of osteoarthritis. Rheumatic Disease Clinics 2013; 39.1: 45-66.
  • 9. Brandt KD, Radin EL, Dieppe PA, Van De Putte L. Yet more evidence that osteoarthritis is not a cartilage disease. Annals of the rheumatic diseases 2006; 65(10), 1261-1264.
  • 10. McGonagle D, Tan AL, Grainger AJ, Benjamin M. Heberden's nodes and what Heberden could not see: the pivotal role of ligaments in the pathogenesis of early nodal osteoarthritis and beyond. Rheumatology 2008; 47(9), 1278-1285.
  • 11. Román-Blas JA, Castañeda S, Largo R, Herrero-Beaumont G. Subchondral bone remodelling and osteoarthritis. Arthritis Research & Therapy 2012;14, 1-8.
  • 12. Kloppenburg M, Kwok WY. Hand osteoarthritis—a heterogeneous disorder. Nature Reviews Rheumatology 2012;8(1), 22-31.
  • 13. Vashishtha A, Kumar-Acharya A. An overview of medical imaging techniques for knee osteoarthritis disease. Biomedical and Pharmacology Journa 2021;14(2), 903-919.
  • 14. Marshall KW, Zhang H, Yager TD, Nossova N, Dempsey A, Zheng R, Liew CC. Blood-based biomarkers for detecting mild osteoarthritis in the human knee. Osteoarthritis and cartilage 2005;13(10), 861-871.
  • 15. Neuprez A, Neuprez AH, Kaux JF, Kurth W, Daniel C, Thirion T, Reginster JY. Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years. Clinical rheumatology 2020; 39, 861-871.
  • 16. Mahendira L, Jones C, Papachristos A, Waddell J, Rubin L. Comparative clinical and cost analysis between surgical and non-surgical intervention for knee osteoarthritis. International Orthopaedics 2020; 44, 77-83.
  • 17. Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, Vlieland TPV. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Annals of the rheumatic diseases 2013;72(7), 1125-1135.
  • 18. Da Costa BR, Pereira TV, Saadat P, Rudnicki M, Iskander SM, Bodmer NS, Jüni P. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis. Bmj 2021; 375.
  • 19. Tetteh ES, Bajaj S, Ghodadra NS, Cole BJ. The basic science and surgical treatment options for articular cartilage injuries of the knee. journal of orthopaedic & sports physical therapy 2012; 42(3), 243-253.
  • 20. Madry H, Grün UW, Knutsen G. Cartilage repair and joint preservation: medical and surgical treatment options. Deutsches Ärzteblatt International 2011;108(40), 669.
  • 21. Ahmad SS, Gantenbein B, Evangelopoulos DS, Schär MO, Schwienbacher S, Kohlhof H, Kohl S. Arthroplasty–current strategies for the management of knee osteoarthritis. Swiss medical weekly 2015; 145(0708), w14096-w14096.
  • 22.Postler A, Lützner C, Beyer F, Tille E, Lützner J. Analysis of total knee arthroplasty revision causes. BMC musculoskeletal disorders 2018; 19, 1-6.
  • 23.Alvand A, Miles J, Carrington R. Surgical strategies formanagement of infection following knee arthroplasty andarthroscopic procedures. Orthopaedics and Trauma 2019; 33(3), 166-174.
  • 24.Madry H. Surgical therapy in osteoarthritis. Osteoarthritis andcartilage 2022;30(8), 1019-1034.
  • 25.Fusco G, Gambaro FM, Di Matteo B, Kon E. Injections in the osteoarthritic knee: a review of current treatment options. Efort Open Reviews 2021; 6(6), 501-509.
  • 26.Koenig KM, Ong KL, Lau EC, Vail TP, Berry DJ, Rubash HE,Bozic KJ. The use of hyaluronic acid and corticosteroid injections among Medicare patients with knee osteoarthritis. The Journal of Arthroplasty 2016;31(2), 351-355.
  • 27.Cook SG, Bonassar LJ. Interaction with cartilage increases the viscosity of hyaluronic acid solutions. ACS BiomaterialsScience & Engineering 2020; 6(5), 2787-2795.
  • 28.Saunders S, Longworth S. Injection techniques inmusculoskeletal medicine: a practical manual for clinicians in primary and secondary care. Elsevier Health Sciences; 2018.
  • 29.Adams ME, Lussier AJ, Peyron JG. A risk-benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee. Drug safety 2020; 23, 115-130.
  • 30.Xu X, Jha AK, Harrington DA, Farach-Carson MC, Jia X. Hyaluronic acid-based hydrogels: from a natural polysaccharide to complex networks. Soft matter 2012;8(12), 3280-3294.
  • 31.Necas JBLBP, Bartosikova L, Brauner P, Kolar JJVM.Hyaluronic acid (hyaluronan): a review. Veterinarni medicina 2008; 53(8), 397-411.
  • 32.Boeriu CG, Springer J, Kooy FK, van den Broek LA, Eggink G.Production methods for hyaluronan. International journal ofcarbohydrate chemistry; 2013.
  • 33.Fallacara A, Baldini E, Manfredini S, Vertuani S. Hyaluronic acid in the third millennium. Polymers 2018; 10(7), 701.
  • 34.Fakhari A, Berkland C. Applications and emerging trends ofhyaluronic acid in tissue engineering, as a dermal filler and inosteoarthritis treatment. Acta biomaterialia 2013; 9(7), 7081-7092.
  • 35.Tiwari S, Bahadur P. Modified hyaluronic acid based materials for biomedical applications. International journal of biological macromolecules 2019;121, 556-571.s
  • 36.Juncan AM, Moisă DG, Santini A, Morgovan C, Rus LL,Vonica-Țincu AL, Loghin F. Advantages of hyaluronic acidand its combination with other bioactive ingredients in cosmeceuticals. Molecules 2021; 26(15), 4429.
  • 37.Mantha S, Pillai S, Khayambashi P, Upadhyay A, Zhang Y, Tao O, Tran SD. Smart hydrogels in tissue engineering andregenerative medicine. Materials 2019; 12(20), 3323.
  • 38.Liao Y, He Q, Zhou F, Zhang J, Liang R, Yao X, Ouyang H.Current intelligent injectable hydrogels for in situ articular cartilage regeneration. Polymer Reviews 2020; 60(2), 203-225.
  • 39.López Ruiz E, Jiménez G, Álvarez Cienfuegos Rodríguez L,Antich Acedo C, Sabata R, Marchal Corrales JA, GálvezMartín P. Advances of hyaluronic acid in stem cell therapy and tissue engineering, including current clinical trials; 2019.
  • 40.Fakhari A, Berkland C. Applications and emerging trends of hyaluronic acid in tissue engineering, as a dermal filler and in osteoarthritis treatment. Acta biomaterialia 2013; 9(7), 7081-7092.
  • 41.Lin X, Tsao CT, Kyomoto M, Zhang M. Injectable natural polymer hydrogels for treatment of knee osteoarthritis. Advanced healthcare materials 2022; 11(9), 2101479.
  • 42.Chen W, Li Z, Wang Z, Gao H, Ding J, He Z. Intraarticular injection of infliximab-loaded thermosensitive hydrogelalleviates pain and protects cartilage in rheumatoid arthritis. Journal of pain research 2020; 3315-3329.
  • 43.Cook SG, Bonassar LJ. Interaction with cartilage increases the viscosity of hyaluronic acid solutions. ACS BiomaterialsScience & Engineering 2020; 6(5), 2787-2795.
  • 44.Aggarwal A, Sempowski IP. Hyaluronic acid injections forknee osteoarthritis. Systematic review of the literature. Canadian Family Physician 2004; 50(2), 249-256.
  • 45.Bruno MC, Cristiano MC, Celia C, d’Avanzo N, Mancuso A, Paolino D, Fresta M. Injectable drug delivery systems forosteoarthritis and rheumatoid arthritis. ACS nano 2022;16(12), 19665-19690.
  • 46.Mou D, Yu Q, Zhang J, Zhou J, Li X, Zhuang W, Yang X.Intra-articular injection of chitosan-based supramolecular hydrogel for osteoarthritis treatment. Tissue Engineering and Regenerative Medicine 2021; 18, 113-125.
  • 47.Kim YS, Guilak F. Engineering hyaluronic acid for the development of new treatment strategies for osteoarthritis. International journal of molecular sciences 2022;23(15), 8662.
  • 48.Adams ME, Lussier AJ, Peyron JG. A risk-benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee. Drug safety 2020; 23, 115-130.
  • 49.Vincent HK, Montero C, Conrad BP, Horodyski M, Connelly J,Martenson M, Vincent KR. “Functional pain,” functional outcomes, and quality of life after hyaluronic acid intra-articular injection for knee osteoarthritis. PM&R 2013; 5(4), 310-318.
  • 50.Rwei SP, Chen SW, Mao CF, Fang HW. Viscoelasticity and wearability of hyaluronate solutions. Biochemical engineering journal 2008; 40(2), 211-217.
Toplam 50 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Biyokimya ve Hücre Biyolojisi (Diğer), Ortopedi, Romatoloji ve Artrit
Bölüm Derleme Makaleler
Yazarlar

Umut Doğu Seçkin 0000-0002-0123-0284

Özgün Selim Germiyan 0000-0001-7077-0965

Yiğit Uyanıkgil 0000-0002-4016-0522

Yayımlanma Tarihi 17 Mayıs 2024
Gönderilme Tarihi 30 Kasım 2023
Kabul Tarihi 16 Nisan 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 50 Sayı: 1

Kaynak Göster

APA Seçkin, U. D., Germiyan, Ö. S., & Uyanıkgil, Y. (2024). Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme ve Klinik Kullanımlarının Değerlendirmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 50(1), 113-119. https://doi.org/10.32708/uutfd.1398661
AMA Seçkin UD, Germiyan ÖS, Uyanıkgil Y. Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme ve Klinik Kullanımlarının Değerlendirmesi. Uludağ Tıp Derg. Mayıs 2024;50(1):113-119. doi:10.32708/uutfd.1398661
Chicago Seçkin, Umut Doğu, Özgün Selim Germiyan, ve Yiğit Uyanıkgil. “Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme Ve Klinik Kullanımlarının Değerlendirmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50, sy. 1 (Mayıs 2024): 113-19. https://doi.org/10.32708/uutfd.1398661.
EndNote Seçkin UD, Germiyan ÖS, Uyanıkgil Y (01 Mayıs 2024) Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme ve Klinik Kullanımlarının Değerlendirmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50 1 113–119.
IEEE U. D. Seçkin, Ö. S. Germiyan, ve Y. Uyanıkgil, “Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme ve Klinik Kullanımlarının Değerlendirmesi”, Uludağ Tıp Derg, c. 50, sy. 1, ss. 113–119, 2024, doi: 10.32708/uutfd.1398661.
ISNAD Seçkin, Umut Doğu vd. “Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme Ve Klinik Kullanımlarının Değerlendirmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 50/1 (Mayıs 2024), 113-119. https://doi.org/10.32708/uutfd.1398661.
JAMA Seçkin UD, Germiyan ÖS, Uyanıkgil Y. Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme ve Klinik Kullanımlarının Değerlendirmesi. Uludağ Tıp Derg. 2024;50:113–119.
MLA Seçkin, Umut Doğu vd. “Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme Ve Klinik Kullanımlarının Değerlendirmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 50, sy. 1, 2024, ss. 113-9, doi:10.32708/uutfd.1398661.
Vancouver Seçkin UD, Germiyan ÖS, Uyanıkgil Y. Osteoartritte Eklem İçi Hyaluronik Asit Enjeksiyonlarının Güvenliği: Sistematik Bir Gözden Geçirme ve Klinik Kullanımlarının Değerlendirmesi. Uludağ Tıp Derg. 2024;50(1):113-9.
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ISSN: 1300-414X, e-ISSN: 2645-9027

Uludağ Üniversitesi Tıp Fakültesi Dergisi "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" ile lisanslanmaktadır.


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Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

2023