Injection Of Sodium Hyaluronate Research Articles

Effect of Articular Cavity Injection Combined with Bite Splint Treatment on Anterior Disc Displacement Without Reduction

Objective: To observe the clinical effect of articular cavity injection combined with bite splint therapy for the treatment of anterior disc displacement without reduction (ADDWoR). Methods: The research subjects for this study were 30 patients with ADDWoR treated in the temporomandibular joint specialist outpatient clinic from November 2018 to November 2019, with a disease duration of 1 to 6 months. The treatment group was treated with an articular cavity injection of sodium hyaluronate + bite splint. The control group was treated with a simple articular cavity injection of sodium hyaluronate. The two groups were followed up once every 2 weeks to evaluate the treatment effect and observe the clinical efficacy of the two groups. Statistical analysis was carried out using SPSS 24.0. t-test and general linear regression analysis were carried out to compare the data of both groups, and χ2-test and binary logistic regression analysis were performed for pain index comparison. Results: There was no significant difference in terms of the efficacy of the treatment received by both groups. The mouth opening and joint pain of patients in both groups were significantly improved after treatment (P < 0.001). Conclusion: Articular cavity injection of sodium hyaluronate and occlusal splint therapy are both effective and safe methods for treating ADDWoR.

Modification of the Suprachoroidal Buckling Technique for the Treatment of Rhegmatogenous Retinal Detachment.

To describe modification of the suprachoroidal buckling technique for the treatment of rhegmatogenous retinal detachment (RRD), which may improve the safety profile. A single-surgeon foot-pedal-controlled automated suprachoroidal injection (SCI) of sodium hyaluronate 1%, namely ProVisc (Alcon Laboratories, Fort Worth, TX) was used for the treatment of RRD. MicroDose Injection Kit (MedOne Surgical, Sarasota, FL) including a connector and a 1-mL syringe, designed for subretinal injection, was used to adapt Constellation Vision System (Alcon Laboratories) console for SCI of ProVisc from the 1-mL syringe. This approach enables better surgeon control during SCI. Three highly myopic eyes of three patients with primary macula-on RRD and single superior peripheral retinal break were treated. Complete retinal reattachment was achieved in all eyes without complications. Injecting ProVisc under foot-pedal control provides a more precise and potentially safer suprachoroidal buckling technique compared with the manual technique with more variable injection speed and pressure.

Application Research of Sodium Hyaluronate in Endoscopic Submucosal Tunnel Resection (STER) for Esophageal Cancer

Objective: This study aims to evaluate the efficacy and safety of submucosal injection using a mixture containing sodium hyaluronate in submucosal tunneling endoscopic resection (STER) for esophageal submucosal tumors (SMTs). Methods: A total of 42 patients with SMTs participated in this study from January 2020 to October 2023. The patients were randomly divided into the experimental group (n=21) and the control group (n=21). The experimental group received a mixture of 5ml sodium hyaluronate injection (50mg) + 25ml fructose sodium chloride injection + 0.1ml methylene blue injection as submucosal injection. The control group received 30ml fructose sodium chloride injection + 0.1ml methylene blue injection. Submucosal injection started 5cm proximal to the SMT in the esophagus using the mixture until effective mucosal elevation for subsequent STER surgery. Results: There was no statistically significant difference in the average diameter of resected specimens between the experimental group (1.9±1.3 cm) and the control group (2.0±1.1cm, P>0.05). The average operation time in the experimental group (70.05±9.93 min) was significantly shorter than the control group (96.29±12.15 min, P<0.05). The average submucosal injection volume in the experimental group (13.52±2.77ml) was significantly lower than the control group (26.38±3.47ml, P<0.05). In cases with bleeding <5ml, the experimental group had 18 cases (86%), while the control group had 4 cases (19%); in cases with bleeding >5ml, the experimental group had 3 cases (14%), and the control group had 17 cases (81%), showing a statistically significant difference (P<0.05). Conclusion: Submucosal injection using a mixture containing sodium hyaluronate for STER surgery not only exhibits excellent efficacy but also high safety.

Topical Chinese patent medicines for chronic musculoskeletal pain: systematic review and trial sequential analysis

PurposeChronic musculoskeletal pain (CMP) is defined as persistent or recurrent pain that occurs in the joints, musculo-soft tissue, spine or bones for more than three months and is not completely curable. Although topical Chinese patent medicine (CPM) is the most extensively utilized medication in Asia and is widely used for pain management, its efficacy remains controversial. This article presents a systematic review of clinical studies on the therapeutic properties of topical CPM for CMP patients to better inform clinical decision-making and provide additional and safer treatment options for patients with CMP.MethodWe performed a comprehensive search on PubMed, Cochrane Library, web of science and Chinese databases (CNKI and WanFang data) from 2010 to 2022. In all the studies, knee osteoarthritis, cervical spondylosis, low back pain, and periarthritis of shoulder met the International Pain Association definition of chronic musculoskeletal pain. We included only randomized controlled trials (RCTs) using topical CPM primarily for chronic musculoskeletal pain in adults. To determine the effect of topical CPM on clinical symptoms, we extracted the Visual Analog Scale (VAS, range 0–10) and the Western Ontario and McMaster Universities Arthritis Index pain scores (WOMAC pain, range 0–20), in which the lower the score, the better the results. We also accepted the comprehensive outcome criteria developed by the Chinese National Institute of Rheumatology as an endpoint (total effectiveness rate, range 0–100%, higher score = better outcome), which assesses the overall pain, physical function and wellness. Finally, trial sequential analysis of VAS pain score and total effectiveness rate was performed using TSA software.ResultsTwenty-six randomized controlled trials (n = 3180 participants) compared topical CPM with oral Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (n = 15), topical NSAIDs (n = 9), physiotherapy (n = 5), exercise therapy (n = 4), and intra-articular Sodium hyaluronate injection (n = 2). Sixteen studies found that topical CPM was statistically significant in improving CMP pain (measured by VAS pain and Womac pain scores)(p < 0.05), and 12 studies found topical CPMs to be more clinically effective (assessed by ≥ 30% reduction in symptom severity) in treating patients with CMP (p < 0.05). Trial sequential analysis indicates that the current available evidence is robust, and further studies cannot reverse this result. In most of the studies, randomisation, allocation concealment and blinding were not sufficiently described, and no placebo-controlled trials were identified.ConclusionMost studies showed superior analgesic effects of topical CPM over various control treatments, suggesting that topical CPM may be effective for CMP and is an additional, safe and reasonable treatment option. These reported benefits should be validated in higher-quality RCTs.

Retracted: Effect of Tongluozhitong Prescription-Assisted Intra-Articular Injection of Sodium Hyaluronate on VAS Score and Knee Lysholm Score in Patients with Knee Osteoarthritis.

[This retracts the article DOI: 10.1155/2021/3210494.].

Effectiveness and safety of an ultrasound-guided injection of platelet-rich plasma versus sodium hyaluronate in patients with knee osteoarthritis

Purpose: To examine the effectiveness and safety of ultrasound-guided platelet-rich plasma (PRP) injection versus sodium hyaluronate injection in patients with knee osteoarthritis (KOA).Methods: The clinical data of 92 patients treated at the West China Hospital Sichuan University-Ziyang Hospital between May 2020 and December 2021 were retrospectively analyzed. Patients were allocated to PRP group (ultrasound-guided PRP injection) and a hyaluronic acid (HA) group (sodium hyaluronate injection) with each group containing 46 patients. Before and after treatment, the two groups were compared in terms of visual analog scale (VAS) score, Lysholm score, levels of serum inflammatory factors, insulin-like growth factor (IGF)-1, fibroblast growth factor (FGF)-2 and WOMAC score.Results: After treatment, PRP group exhibited significantly lower pain scores and higher function scores than HA group. Furthermore, PRP group exhibited lower levels of inflammation markers, higher levels of growth factors as well as better treatment efficiency and incidence of adverse reactions when compared with HA group (p &lt; 0.05).Conclusion: Ultrasound-guided PRP therapy ameliorates pains and joint functions in KOA patients. The therapeutic effect may be associated with the regulation of cartilage performance and alleviation of inflammatory state. Therefore, PRP injection therapy combined with ultrasound guidance might also have clinical potential for other applications.

Intravenous Injection of Sodium Hyaluronate Diminishes Basal Inflammatory Gene Expression in Equine Skeletal Muscle.

Following strenuous exercise, skeletal muscle experiences an acute inflammatory state that initiates the repair process. Systemic hyaluronic acid (HA) is injected to horses routinely as a joint anti-inflammatory. To gain insight into the effects of HA on skeletal muscle, adult Thoroughbred geldings (n = 6) were injected with a commercial HA product weekly for 3 weeks prior to performing a submaximal exercise test. Gluteal muscle (GM) biopsies were obtained before and 1 h after exercise for gene expression analysis and HA localization. The results from RNA sequencing demonstrate differences in gene expression between non-injected controls (CON; n = 6) and HA horses. Prior to exercise, HA horses contained fewer (p < 0.05) transcripts associated with leukocyte activity and cytokine production than CON. The performance of exercise resulted in the upregulation (p < 0.05) of several cytokine genes and their signaling intermediates, indicating that HA does not suppress the normal inflammatory response to exercise. The transcript abundance for marker genes of neutrophils (NCF2) and macrophages (CD163) was greater (p < 0.05) post-exercise and was unaffected by HA injection. The anti-inflammatory effects of HA on muscle are indirect as no differences (p > 0.05) in the relative amount of the macromolecule was observed between the CON and HA fiber extracellular matrix (ECM). However, exercise tended (p = 0.10) to cause an increase in ECM size suggestive of muscle damage and remodeling. The finding was supported by the increased (p < 0.05) expression of CTGF, TGFβ1, MMP9, TIMP4 and Col4A1. Collectively, the results validate HA as an anti-inflammatory aid that does not disrupt the normal post-exercise muscle repair process.

Efficacy of acupotomy combined with sodium hyaluronate versus sodium hyaluronate alone in the treatment of knee osteoarthritis: A meta-analysis.

The efficacy of acupotomy combined with hyaluronic sodium acid in the treatment of knee osteoarthritis (KOA) is unclear. Therefore, this meta-analysis aims to evaluate the efficacy of acupotomy combined with hyaluronic sodium acid compared with hyaluronic sodium acid alone in the treatment of KOA. Studies from 8 Online databases were searched on KOA treatment using acupotomy combined with sodium hyaluronate until May 2022. The primary outcome indicator was clinical effectiveness, and the secondary outcome indicators included the visual analogue scale scores and Lysholm scores. We calculated the weighted mean difference (WMD) or relative risk for all relevant outcomes. Nine studies were identified, involving 644 cases. The results showed that acupotomy combined with intra-articular sodium hyaluronate injection for KOA was superior to sodium hyaluronate injection alone in terms of clinical effectiveness (relative risk = 1.17, 95% confidence interval [CI]: 1.09-1.25, P < .001) and visual analogue scale (WMD = -2.1, 95% CI: -2.25 to 1.95, P < .001), Lysholm score (WMD = 13.83, 95% CI: 3.47-24.19, P = .009). Acupotomy combined with intra-articular sodium hyaluronate injection for KOA is superior to sodium hyaluronate injection alone. Limited by the number and quality of included studies, this conclusion still needs to be verified by more high-quality Research. INPLASY202350029.

In-Office Suprachoroidal Viscopexy for Rhegmatogenous Retinal Detachment Repair

In-office suprachoroidal viscopexy (SCVEXY) is a minimally invasive technique for rhegmatogenous retinal detachment (RRD) repair that can be performed with no incision, no tamponade agent, and no positioning requirements. This technique has the potential to be a step forward in the armamentarium to treat RRDs. To describe in-office SCVEXY for RRD repair. In this single-case report with short follow-up, a man in his 50s with pseudophakia and recent visual loss presented to St Michael's Hospital, Unity Health Toronto, with a fovea-off RRD in the right eye, extending from 6 to 10 o'clock, with no visible causative retinal break. Injection of suprachoroidal sodium hyaluronate, 1%, in the region of the suspected break, using a 30-gauge needle with a custom-made guard that exposed only 1 mm of the needle. Ability to perform in-office SCVEXY and to obtain a visible choroidal indentation. After the procedure, a dome-shaped choroidal convexity was present in the superior temporal area. The patient achieved macular reattachment in less than 24 hours with no postoperative abnormalities, such as outer retinal folds, residual subfoveal fluid, or retinal displacement, with rapid recovery of the outer retinal bands on optical coherence tomography. The optical coherence tomography scans acquired in the area of the choroidal convexity demonstrated the location of the viscoelastic material in the suprachoroidal space. Laser retinopexy was applied in the suspected region of the retinal tear, and the patient was able to resume normal activity immediately after the procedure with no restrictions. Suprachoroidal viscopexy is feasible as an in-office technique to create a temporary choroidal buckle for RRD repair. It is a minimally invasive procedure with the potential to maximize anatomical outcomes of integrity and postoperative functional outcomes in RRD because its mechanism of action does not require drainage of subretinal fluid or intraocular gas tamponade. Nevertheless, this was a single-case report with short follow-up, which limits the ability to determine the procedure's benefits, potential adverse events, failure rates, and best-case selection. Further work is required to refine the procedure and assess its efficacy and safety.

Injection of Hyaluronic Acid versus Steroid Guided by Ultrasound in Management of Rotator Cuff Tendinopathy

Aim of the Work To compare effect of injection of sodium hyaluronate versus steroid guided by ultrasound in treatment of rotator cuff tendinopathy. Aim of the Work To compare effect of injection of sodium hyaluronate versus steroid guided by ultrasound in treatment of rotator cuff tendinopathy. Patient and Methods This study was conducted on 30 patients with shoulder pain. All patients were subjected to history taking, clinical examination and laboratory investigations together with diagnostic musculoskeletal ultrasound. Pain and function scores were assessed using the visual analog scale(VAS), Oxford shoulder score (OSS), and Constant shoulder score (CSS). All patients were randomly assigned into one of two groups; Group I received single steroid injection, Group II received single hyaluronic acid injection. Patients were re-assessed after 2 months of injections. Results After 2 months of injection, both groups showed improvement regarding CSS, OSS and VAS and the difference between pre-injection and post-injection was highly significant regarding all three parameters (p &amp;lt; 0.001). On comparison between groups; Group II showed highly significant improvement regarding CSS and VAS compared to group I (P &amp;lt; 0.001). However, there was no difference in OSS between two groups (p &amp;gt; 0.05). Conclusion Hyaluronic acid injection offers better therapeutic advantages over a corticosteroid injection in the treatment of rotator cuff tendinopathy especially in the short term follow up.

Is the Rate of Responders to Hyaluronic Acid Injection for Patients with Knee Osteoarthritis Stable Over Time? Post hoc Analyses of a 6-Month Follow-Up Study.

Recently, a study showing the non-inferiority of a single injection of sodium hyaluronate plus sorbitol (Synolis VA®) compared to hylan G-F20 (Synvisc-One®) over a 24-week period in patients with knee osteoarthritis was published. The objective of the present study is to assess if a short-term response to a single injection of sodium hyaluronate plus sorbitol can be maintained over a 6month-period and if the maintenance of the response to treatment is dependent on the functional status at baseline. Responders to treatment at days 28, 84, and 168 were evaluated according to the responder criteria proposed by the OMERACT-OARSI. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to assess functional status at baseline. All analyses were adjusted for age, gender, BMI, and baseline WOMAC total score using data from the intention-to-treat (ITT) population. Out of the 96 patients included in the study who were receiving Synolis VA®, 59.38% were responders at day 28 according to the OMERACT/OARSI responder criteria, 59.78% at day 84, and 64.52% at day 168. Among the responders at D28, the probability of being responder at D84 and D168 was significantly higher than among non-responders, with corresponding odds ratio (95% CI) of 2.85 (1.07-7.59) and 7.28 (2.53-20.93), respectively. Patients with a poorer physical function at baseline were more likely to respond to the treatment at all time points, compared to those with a better physical function (OR 3.74 [1.37-10.21]). An early response of a single injection of sodium hyaluronate plus sorbitol is predictive of long-term response, up to 24weeks. Patients with a poorer physical function may best benefit from the treatment.

Clinical effects of sodium hyaluronate combined with platelet-rich plasma injection on rotator cuff injury in arthroscopic repair

ObjectiveRotator cuff injury is one prevalent shoulder condition that often leads to pain and dysfunction. The study explored the clinical effects of sodium hyaluronate combined with platelet-rich plasma (PRP) injection on rotator cuff injury in arthroscopic repair. MethodsA total of 92 cases with rotator cuff injury were randomly divided into the control group (n = 46, treated with shoulder arthroscopy repair combined with subacromial space injection of sodium hyaluronate) and the experimental group (n = 46, treated with subacromial space injection of autologous PRP on the basis of the treatment in the control group). Visual analogue scale (VAS), Constant-Murley scale (CMS), University of California, Los Angeles (UCLA), American Shoulder and Elbow Society (ASES), and quality of life (QOL) scores, as well as complications were compared in the two groups before surgery and at 3 and 6 months after surgery. Shoulder range of motion (ROM) was measured before and after surgery. ResultsVAS scores of patients in the two groups at 3 and 6 months after surgery were lower than those before surgery, and the VAS scores of patients in the experimental group at 3 and 6 months after surgery were much lower than those in the control group (all P < 0.05). The scores of CMS, UCLA, ASES, and QOL, and shoulder ROM in both groups at 3 and 6 months after surgery were higher than those before surgery, and these shoulder joint function scores, QOL and shoulder ROM in the experimental group at 3 and 6 months after surgery were higher than those in the control group (all P < 0.05). No statistically significant difference presented in the incidence of complications between the two groups (P > 0.05). ConclusionArthroscopic rotator cuff repair and sodium hyaluronate combined with PRP injection can effectively reduce pain symptoms, improve shoulder joint function and shoulder ROM, and improve QOL in patients with rotator cuff injury.

Efficacy of Arthrocentesis with and Without Sodium Hyaluronate Injection for Temporomandibular Joint Disorders: A Comparative Study.

To evaluate the efficacy of arthrocentesis with and without sodium hyaluronate injection for internal derangement of temporomandibular joint. Patients with clinically and radiographically confirmed cases of temporomandibular joint disorders were enrolled for this study. 20 patients were randomly allocated into two groups for arthrocentesis of TMJ with 10 patients in each group. In group 1, patients were treated with TMJ arthrocentesis followed by sodium hyaluronate injection, and in group 2, patients were treated with arthrocentesis alone. All the patients were treated under local anaesthesia. The patients were followed up at 1st week, 2nd week, 4th week and 12th week post operatively for maximum mouth opening, lateral mandibular movements, pain at rest and on mastication and the subjective efficacy of the treatment. By the end of twelfth week follow up, the mean mouth opening showed significant improvement in group 1, the right and left lateral movements showed better results in group 1 than in group 2, pain at rest and pain on mastication were mild in both the groups with subjective efficacy good in group 1 and moderate in group 2. This study suggested that TMJ arthrocentesis with sodium hyaluronate injection had better clinical outcome compared to TMJ arthrocentesis alone for TMJ disorders.

Acute Pseudoseptic Arthritis after Intra-Articular Sodium Hyaluronate Injection: A Case Report and Literature Review

Purpose: This report describes the case of 59-year-old woman with right medial compartment knee osteoarthritis (OA) who experienced an unusual adverse reaction to intra-articular sodium hyaluronate injection. Methods: The patient received an intra-articular sodium hyaluronate injection for treatment of knee OA. Ten days after injection, she experienced severe pain in her right knee wherein laboratory test results showed inflammatory profiles that could not rule out septic arthritis. Joint lavage was performed, after which the patient was monitored for any changes in her symptoms or laboratory test results. Results: The patient experienced severe pain in her right knee after intra-articular sodium hyaluronate injection. Additionally, laboratory test results showed inflammatory profiles that could not rule out septic arthritis. One month after joint lavage, the patient's symptoms resolved, and her laboratory test results returned to normal range. Conclusions: An inflammatory flare could occur as an adverse effect of intra-articular sodium hyaluronate injection, mimicking septic arthritis. Importantly, both physicians and patients should be aware of this potential reaction, particularly, patients should report any unusual symptoms to their healthcare provider.

Efficacy and Safety of Intra-Articular Cross-Linked Sodium Hyaluronate for the Treatment of Knee Osteoarthritis: A Prospective, Active-Controlled, Randomized, Parallel-Group, Double-Blind, Multicenter Study.

The safety and efficacy of Hyruan ONE (test product), an intra-articular cross-linked sodium hyaluronate injection, to treat mild-to-moderate knee osteoarthritis was compared with that of Durolane (comparator) in a prospective, active-controlled, parallel-group, double-blind (masked-observed), multicenter non-inferiority study. European patients (n = 284) were randomized 1:1 (test product:comparator) and received one injection of cross-linked hyaluronic acid (60 mg/3 mL). In total, 280 patients completed the study. The primary endpoint of mean change in Western Ontario and McMaster University (WOMAC)-Likert Pain sub-scores from baseline at week 13 revealed changes of -5.59 and -5.54 for the test and comparator groups, respectively, demonstrating non-inferiority of the test product (difference, -0.05 [95% confidence interval, -0.838 to 0.729]). Secondary endpoint results, which included changes in WOMAC-Likert Pain sub-score from baseline to 26 weeks post-injection and changes in WOMAC-Likert Total score and Physical Function and Stiffness sub-scores, changes in patients' and investigators' global assessments, use of rescue medication, and responder rates at 13 and 26 weeks post-injection were similar between the groups. Incidence of adverse events was also similar. In both groups, most treatment-emergent adverse events were mild/moderate. Hyruan ONE was non-inferior to the comparator at 13 weeks post-injection in European patients with mild-to-moderate knee osteoarthritis.

Evaluation of the Anti-inflammatory Effect of Intra-articular Injection of Chondroitin Sulfate and Sodium Hyaluronate in Mechanically Induced Temporomandibular Joint Injury in Rabbits

BACKGROUND: Degenerative arthritis is the most common form of arthritis, usually affecting the hands, feet, spine, knees, and temporomandibular joint (TMJ) as well. TMJ degenerative arthritis causes symptoms of painful joints, loss of joint function, limited mouth opening, joint instability, and clicking. Non-surgical symptomatic treatments can successfully be used to treat patients with degenerative arthritis. AIM: This study aimed to evaluate the anti-inflammatory effect of intra-articular injection of chondroitin sulfate and sodium hyaluronate in mechanically induced acute injury in TMJ of rabbits. METHODS: An animal study was conducted, all rabbits received a mechanical injury using a contra-angle handpiece with a speed of 120 rpm of a fissure bur 4 mm in diameter and 4 mm in depth extending to subchondral bone. Thirty-two rabbits were randomized into four groups: Control group, sodium hyaluronate “SH” group, chondroitin sulfate “CS” group, and “CS-SH” group. After 7 days, rabbits in the control group, “SH” group, “CS” group, and “CS-SH” group were respectively treated with normal saline, sodium hyaluronate, chondroitin sulfate, or combination of CS&amp;SH injection in the TMJ. All animals were treated once weekly for 3 weeks. A histological evaluation was performed. RESULTS: Histological findings showed a significantly reduced inflammatory cell, bone resorption, and fibrosis in the CS-HA-treated group. CONCLUSION: CS-SH injection has an anti-inflammatory effect on TMJ degenerative arthritis and aids in the reparative process.

Investigations into photoreceptor energy metabolism during experimental retinal detachment.

Retinal detachment is a sight-threatening disorder, which occurs when the photoreceptors are separated from their vascular supply. The aim of the present study was to shed light on photoreceptor energy metabolism during experimental detachment in rats. Retinal detachment was induced in the eyes of rats via subretinal injection of sodium hyaluronate. Initially, we investigated whether detachment caused hypoxia within photoreceptors, as evaluated by the exogenous and endogenous biomarkers pimonidazole and HIF-1α, as well as by qPCR analysis of HIF target genes. The results showed no unequivocal staining for pimonidazole or HIF-1α within any detached retina, nor upregulation of HIF target genes, suggesting that any reduction in pO2 is of insufficient magnitude to produce hypoxia-induced covalent protein adducts or HIF-1α stabilisation. Subsequently, we analysed expression of cellular bioenergetic enzymes in photoreceptors during detachment. We documented loss of mitochondrial, and downregulation of glycolytic enzymes during detachment, indicating that photoreceptors have reduced energetic requirements and/or capacity. Given that detachment did not cause widespread hypoxia, but did result in downregulated expression of bioenergetic enzymes, we hypothesised that substrate insufficiency may be critical in terms of pathogenesis, and that boosting metabolic inputs may preserve photoreceptor bioenergetic production and, protect against their degeneration. Thus, we tested whether supplementation with the bioavailable energy substrate pyruvate mitigated rod and cone injury and degeneration. Despite protecting photoreceptors in culture from nutrient deprivation, pyruvate failed to protect against apoptotic death of rods, loss of cone opsins, and loss of inner segment mitochondria, in situ, when evaluated at 3 days after detachment. The regimen was also ineffective against cumulative photoreceptor deconstruction and degeneration when evaluated after 4 weeks. Retinal metabolism, particularly the bioenergetic profiles and pathological responses of the various cellular subtypes still presents a considerable knowledge gap that has important clinical consequences. While our data do not support the use of pyruvate supplementation as a means of protecting detached photoreceptors, they do provide a foundation and motivation for future research in this area.

Clinical Evaluation of Intra-Articular Injection of Chondroitin Sulfate and Sodium Hyaluronate in the Management of Degenerative Osteoarthritis of Temporomandibular Joint

AIM: This study aims to evaluate the effectiveness of intra-articular injection of chondroitin sulfate and sodium hyaluronate in cases of temporomandibular joint (TMJ) degenerative osteoarthritis. MATERIAL AND METHODS: Thirty patients ASA I of both sexes, who were selected from outpatient clinic of Oral Surgery Department, Faculty of Dentistry – Suez Canal University, complaining of painful TMJ, presence of unilateral or bilateral TMJ pain, impairment of jaw movements, and joint sounds. Clinical examination was performed to all patients and pre-operative measurements of visual analog scale (VAS) for morning pain, pain with movement and spontaneous pain, maximum mouth opening, and presence or absence of clicking. Patients were randomly divided into two groups; (a) Study group consisted of 15 patients, they had intra-articular injection of chondroitin sulfate and sodium hyaluronate once weekly for 3 weeks and (b) control group consisted of 15 patients, they had intra-articular injection of sodium hyaluronate once weekly for 3 weeks. Post-operative measurements of VAS for previous pain types, maximum mouth opening, and clicking were obtained at 1 month, 3 months, and 6 months post-injection. RESULTS: There was a statistically significant reduction of all types of pain in the study group compared to the control group at all time intervals (p ≤ 0.05), for maximum mouth opening, there was a significant improvement in mouth opening in the study group for all time intervals (p ≤ 0.05), but for the clicking, there was not statistically significant difference between the study and control groups after 1 month, 3 months, and 6 months. The difference between groups was barely statistically significant (p = 0.05). CONCLUSION: Intra-articular injection of a combination of chondroitin sulfate and sodium hyaluronate is an effective tool in reducing pain, clicking, limited mouth opening, and other symptoms associated with degenerative TMJ diseases.

Medium-Term Effect of Treatment with Intra-Articular Injection of Sodium Hyaluronate, Betamethasone and Platelet-Rich Plasma in Patients with Temporomandibular Arthralgia: A Retrospective Cohort Study.

Temporomandibular joint disorders are associated with pain and reduced jaw mobility. The aim of this study was to compare the long-term effect on pain of intra-articular TMJ injections of betamethasone, sodium hyaluronate and platelet-rich plasma. The sample was made up of 114 patients, who were randomly distributed into three groups at least three years ago and who achieved a total remission of pain after treatment. We found that the median number of months without pain was, according to each group, as follows: platelet-rich plasma: 33; sodium hyaluronate: 28; betamethasone: 19. Both platelet-rich plasma and sodium hyaluronate lead to significant pain-free time after treatment; when we compare bethametasone with the two other substances, it proved to be very ineffective.

Acupotomy combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis.

This retrospective study aimed to compare the effects of acupotomy combined with intra-articular injection of sodium hyaluronate (IA-SH) for the treatment of knee osteoarthritis (KOA). Eighty electronic medical records of patients with KOA were retrospectively analyzed. The patients were divided into an intervention group (n = 40, acupotomy plus IA-SH) and a control group (n = 40, IA-SH). Outcome measures included the visual analog scale, the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and adverse events. Outcome data were collected and analyzed before and after treatment. The results of this study showed that there was a greater reduction in the visual analog scale (P < .01) and WOMAC scores (pain, P < .01; stiffness, P < .01; function, P < .01; total, P < .01) in the intervention group than in the control group. In addition, there were no significant differences in adverse events between the 2 groups. In this study, the effects of acupotomy plus IA-SH were superior to those of IA-SH alone for the treatment of patients with KOA. Further prospective studies are required to confirm these findings.