Abstract
The article discusses the treatment of osteoarthritis (OA) as the most common joint disease. The recommendations from professional associations for the patient management in OA using hyaluronic acid (HA) preparations differ somewhat depending on the affected joint, although they generally indicate positive effects of their use. Studies have shown the HA participation in the phagocytosis reduction, as well as in lowering the levels of prostaglandins, fibronectin, cAMP and a number of other anti-inflammatory effects. There is also a hypothesis that HA can prevent the release of arachidonic acid, block nociceptors and reduce the bradykinin formation, as well as it has chondroprotective properties. At the same time, total joint replacement is considered optimal (which has proven itself to be an effective and safe type of surgery) during the OA progression, the preservation of severe pain and loss of joint function, and the inefficacy of conservative treatment. The authors draw attention to the most common complication that occurs during total joint replacement — contralateral limb pain, and explain the mechanisms of its progression. They also present their case follow-ups of patients after total joint replacement with the development of synovitis in the contralateral hip joint and synovitis in combination with ligamentitis in the contralateral knee joint. Besides, the article highlights the clinical picture patterns and the methods of reconstructive local injection therapy with HA. KEYWORDS: osteoarthritis, knee joint, hip joint, hyaluronic acid, total joint replacement, contralateral limb pain, intra-articular injection, periarticular injection. FOR CITATION: Filatova Yu.S., Solovyov I.N., Solovyov E.I. Reconstructive local injection therapy. Russian Medical Inquiry. 2024;8(4):208– 214 (in Russ.). DOI: 10.32364/2587-6821-2024-8-4-4.
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