Abstract
Tendinopathies are common causes of pain and disability in general population and athletes. Conservative treatment is largely preferred, and eccentric exercise or other modalities of therapeutic exercises are recommended. However, this approach requests several weeks of consecutive treatment and could be discouraging. In the last years, injections of different formulations were evaluated to accelerate functional recovery in combination with usual therapy. Hyaluronic acid (HA) preparations were proposed, in particular LMW-HA (500–730 kDa) for its unique molecular characteristics in favored extracellular matrix homeostasis and tenocyte viability. The purpose of our review is to evaluate the state-of-the-art about the role of 500–730 kDa in tendinopathies considering both preclinical and clinical findings and encourage further research on this emerging topic.
Highlights
Molecular Weight Hyaluronic AcidTendinopathy is multifactorial pathology, that could lead to chronic pain and functional impairment [1]
Tendinopathies are characterized by disorganization of collagen fibers with dysregulation in extracellular matrix homeostasis, alteration in proteoglycan content, enhanced tenocyte apoptosis, and increase in the microvasculature and sensory nerve innervations [19,21]
Tendinopathies are a group of pathologies that afflict the tendons and nowadays there are many current treatment options, but none has shown particular superiority
Summary
Molecular Weight Hyaluronic AcidTendinopathy is multifactorial pathology, that could lead to chronic pain and functional impairment [1]. Tendinopathies can occur in acute and chronic state and can be supported by different factors both intrinsic (age [10], body structure [11], nutrition [12], metabolic diseases [13,14], genetics [15]) and extrinsic (excessive and improper fatigue [8,16], detraining [17], and external damage [18,19,20]) factors. All these factors seem to be related to the appearance of overload tendinopathy a cause–effect relationship has not yet been demonstrated. Tendinopathies are characterized by disorganization of collagen fibers with dysregulation in extracellular matrix homeostasis, alteration in proteoglycan content, enhanced tenocyte apoptosis, and increase in the microvasculature and sensory nerve innervations [19,21]
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