Статті в журналах: "Intra-Articular administration"

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Raza, Hamid, Bashir Ahmed, and Kamlaish -. "INTRA ARTICULAR ADMINISTRATION;." Professional Medical Journal 24, no. 06 (June 5, 2017): 924–29. http://dx.doi.org/10.29309/tpmj/2017.24.06.1121.

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Objectives: The aim of our study is to provide a comparison betweenlevobupivacaine and bupivacaine administered intra articulary in the knee joint duringarthroplasty procedures, and compare the postoperative analgesic effects. Method: StudyDesign: Randomized control trial. Period: One year duration from March 2015 to March 2016.Setting: Tertiary care centre in Karachi, Pakistan. The study population consisted of n= 50patients belonging to ASA class II and III, who were scheduled to undergo TKA (total kneearthroplasty). The patient population was divided into two groups, group A consisted of all thepatients who received bupivacaine, and group B consisted of all the patients who receivedlevobupivacaine. All the patients were between the ages of 18 and 70 years, and had normaljoint mobility. After explaining the procedure and taking due informed consent, the patientswere informed about the use of the visual analog scale for pain and the patients controlledepidural anesthesia (PCEA). Readings of echocardiograph, blood pressure and pulse oximetry,sensory and motor characteristics of the established block, side effects, number of bolusesand doses of PCEA, total amount of pain relief medications utilized over the period, VAS scoresand time of mobilization and discharge from the hospital were also noted in a pre-designed.Statistical analysis was done using SPSS version 23. Results: The study population consistedof n= 50 patients. The VAS scores at were found to be lower in the bupivacaine group at 4,8,12and 24 hours and VAS scores at 48 hour were lower in levobupivacaine group having a p valueof less than 0.05, but the VAS scores were similar at the 0,2 and 72 hours in both the groups.The post-operative analgesic requirement was similar for both groups. The sensation of painat the time of post-operative physiotherapy measure with the VAS score, was also similar inthe two groups having a p value of less than 0.05. Similar results were found between the timeof discharge and time of mobility, having a p value of less than 0.05. Conclusion: The use ofmultimodal analgesia with the administration of intra articular local anesthetics combined withPCEA is a very effective method to provide post-operative pain relief in patients undergoing totalknee arthroplasty.

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Bagri, Narendra Kumar, and Saroj Kumar Tripathy. "Intra-articular Corticosteroid Administration." Indian Pediatrics 55, no. 7 (July 2018): 612. http://dx.doi.org/10.1007/s13312-018-1310-8.

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Lee, Lin-Chien, Fu-Kong Lieu, Hung-Lin Lee, and Tao-Hsin Tung. "Effectiveness of Hyaluronic Acid Administration in Treating Adhesive Capsulitis of the Shoulder: A Systematic Review of Randomized Controlled Trials." BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/314120.

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Introduction. Adhesive capsulitis (AC) of the shoulder presents with an insidious onset of pain and progressive limitation of shoulder movement.Objectives. To investigate whether intra-articular hyaluronic acid (HA) administration alone is superior to conventional therapies and whether the addition of intra-articular HA administration to conventional therapies improves clinical outcomes in patients with AC.Methods. The PubMed, EMBASE, CINAHL, and Cochrane Library electronic databases were searched without language restrictions in July 2014 witha prioridefined inclusion and exclusion criteria.Results. Four randomized controlled trials (273 participants, 278 shoulders) were included in this review. Two trials compared intra-articular HA administration with conventional therapies and 2 trials evaluated intra-articular HA administration as an addition to conventional therapies. Pain and shoulder function/disability outcomes in the HA injection group were not superior to those achieved in the conventional therapy groups. No significant differences in pain or shoulder function/disability outcomes were noted between the groups with and without adjunctive HA administration.Conclusions. Intra-articular HA administration alone is not superior to conventional AC treatments, and the addition of intra-articular HA administration to conventional therapies does not provide significant added benefits. HA administration in AC patients who are receiving conventional therapies should be evaluated to avoid unnecessary medical expenditure.

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Haerdi-Landerer, M. Christina, Maja M. Suter, and Adrian Steiner. "Intra-articular administration of doxycycline in calves." American Journal of Veterinary Research 68, no. 12 (December 2007): 1324–31. http://dx.doi.org/10.2460/ajvr.68.12.1324.

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Derendorf, Hartmut, Helmut Möllmann, G. Voortman, Frank A. van den Ouweland, Levinus B. A. VAN, de Putte, Greet Gevers, Jan Dequeker, and E. VAN Vliet-Daskaiopoulou. "Pharmacokinetics of Rimexolone After Intra-Articular Administration." Journal of Clinical Pharmacology 30, no. 5 (May 1990): 476–79. http://dx.doi.org/10.1002/j.1552-4604.1990.tb03488.x.

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Lawrie, Charles Murray, Gregory S. Kazarian, Toby Barrack, Ryan M. Nunley, and Robert L. Barrack. "Intra-articular administration of vancomycin and tobramycin during primary cementless total knee arthroplasty." Bone & Joint Journal 103-B, no. 11 (November 1, 2021): 1702–8. http://dx.doi.org/10.1302/0301-620x.103b11.bjj-2020-2453.r1.

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Aims Intra-articular administration of antibiotics during primary total knee arthroplasty (TKA) may represent a safe, cost-effective strategy to reduce the risk of acute periprosthetic joint infection (PJI). Vancomycin with an aminoglycoside provides antimicrobial cover for most organisms isolated from acute PJI after TKA. However, the intra-articular doses required to achieve sustained therapeutic intra-articular levels while remaining below toxic serum levels is unknown. The purpose of this study is to determine the intra-articular and serum levels of vancomycin and tobramycin over the first 24 hours postoperatively after intra-articular administration in primary cementless TKA. Methods A prospective cohort study was performed. Patients were excluded if they had poor renal function, known allergic reaction to vancomycin or tobramycin, received intravenous vancomycin, or were scheduled for same-day discharge. All patients received 600 mg tobramycin and 1 g of vancomycin powder suspended in 25 cc of normal saline and injected into the joint after closure of the arthrotomy. Serum from peripheral venous blood and drain fluid samples were collected at one, four, and 24 hours postoperatively. All concentrations are reported in µg per ml. Results A total of 22 patients were included in final analysis. At one, four, and 24 hours postoperatively, mean (95% confidence interval (CI)) serum concentrations were 2.4 (0.7 to 4.1), 5.0 (3.1 to 6.9), and 4.8 (2.8 to 6.9) for vancomycin and 4.9 (3.4 to 6.3), 7.0 (5.8 to 8.2), and 1.3 (0.8 to 1.8) for tobramycin; intra-articular concentrations were 1,900.6 (1,492.5 to 2,308.8), 717.9 (485.5 to 950.3), and 162.2 (20.5 to 304.0) for vancomycin and 2,105.3 (1,389.9 to 2,820.6), 403.2 (266.6 to 539.7), and 98.8 (0 to 206.5) for tobramycin. Conclusion Intra-articular administration of 1 g of vancomycin and 600 mg of tobramycin as a solution after closure of the arthrotomy in primary cementless TKA achieves therapeutic intra-articular concentrations over the first 24 hours postoperatively and does not reach sustained toxic levels in peripheral blood. Cite this article: Bone Joint J 2021;103-B(11):1702–1708.

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Nosivets, Dmitriy. "Intraarticular administration of chondroitin sulfate in experimental osteoarthritis." European Journal of Clinical and Experimental Medicine 20, no. 2 (2022): 185–93. http://dx.doi.org/10.15584/ejcem.2022.2.7.

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Introduction and aim. Osteoarthritis (OA) is generally a progressive disease that affects synovial joints, resulting in abnormalities to articular cartilage subchondral bone, synovium, and adjacent soft tissues. The purpose of this work was to investigate the specific activity of chondroitin sulfate (CS) in intra-articular and intramuscular administration to laboratory rabbits in experimental OA. Material and methods. OA was induced in rabbits by a single injection of mono-iodoacetate in knee joint. CS was administered intra-articularly and intramuscularly. The analysis of biochemical markers and macroscopic assessment of rabbit knee joints was performed. Results. Intramuscular and intra-articular injection of CS reduces the intensity of the degenerative-dystrophic process due to the impact on inflammatory and the activation of anabolic mechanisms. Intra-articular administration of CS leads to a greater increase in the level of factors of bone and cartilage formation and a greater decrease in the levels of factors of the acute phase of inflammation and factors that destroy the cartilage matrix. Conclusion. Intramuscular administration of CS revealed a lower intensity of destructive changes in the cartilaginous surface of the knee joint, and intramuscular – the absence of cartilage destruction and defects of the cartilaginous surface, which indicates the peculiarity of the topical effect of the CS.

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Parker, Lindsay A., Brandan Wustefeld-Janssens, and James M. Dundas. "Transient Postoperative Hemorrhage from Elbow Arthroscopy Portals following Intra-Articular Pentosan Polysulfate Sodium Injection." Case Reports in Veterinary Medicine 2022 (September 29, 2022): 1–6. http://dx.doi.org/10.1155/2022/9428539.

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Four adult, client owned dogs with diagnosed bilateral elbow dysplasia undergoing elbow arthroscopy for removal of fragmented medial coronoid process were identified via a retrospective database search, who also received intra-articular administration of pentosan polysulfate sodium (PPS) (Cartrophen Vet, Biopharm Australia Pty Ltd., Bondi Junction, New South Wales). Dogs had postoperative administration of 5 ml PPS injected into each elbow joint following elbow arthroscopy. Within 1-3 hours of administration, each dog experienced hemorrhage from arthroscopy incisions that was determined to be independent of surgical trauma given lack of hemorrhage intraoperatively. Pressure bandages were placed, and the hemorrhage and elevated coagulation parameters resolved 12-18 hours following intra-articular injection. No further intervention was required, and the dogs were discharged 20-26 hours postoperatively. The purpose of this case series is to describe 4 dogs who experienced transient and focal hemorrhage following off-label intra-articular administration of pentosan polysulfate sodium (PPS). While this case series is limited due to small number of cases, results following bilateral, intra-articular injection of PPS support a transient systemic coagulopathy. Though this report represents administration of PSS via a route and at doses beyond that recommended on the label, results suggest that administration of PSS in the manner described in this report should be avoided.

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Amin, Muhammad Suhail, Muhammad Khurram Habib, and Aziz Ur Rehman. "Comparison of blood loss between intra-articular and intra-venous administration of tranexamic acid in primary total knee arthroplasty." SICOT-J 6 (2020): 20. http://dx.doi.org/10.1051/sicotj/2020017.

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Objective: To compare the blood loss between intra-articular and intra-venous administration of tranexamic acid (TXA) in patients undergoing primary total knee arthroplasty. Design of study: It was a randomized controlled trial. Study duration and settings: This study was carried out at the Orthopedic Departments of Combined Military Hospital Lahore and Rawalpindi from Jan 2016 to March 2018. Methodology: Patients of both the genders were involved this study who had age in the rage of 40–80 years undergoing primary unilateral total knee arthroplasty for degenerative conditions like osteoarthritis and rheumatoid arthritis. These patients were randomly divided into two treatment groups. Patients in IA group received intra-articular tranexamic acid while those in IV group received intravenous tranexamic acid. From all the patients, a written signed consent was taken. Findings: Females were predominant with male-to-female ratio of 1:3.7. The mean age of the patients was 67.3 ± 8.2 years while the mean BMI was 30.9 ± 2.9 Kg/m2. Majority (n = 191, 95.5%) of the patients had osteoarthritis while remaining 9 (4.5%) patients had rheumatoid arthritis. There was no statistically significant difference between intra-articular and intra-venous administration of tranexamic acid in terms of mean post-operative hemoglobin (9.93 ± 1.14 vs. 9.87 ± 1.26 g/dL; p-value = 0.724), mean post-operative hematocrit (34.8 ± 1.66 vs. 34.73 ± 1.27%; p-value = 0.594), and mean fall in hemoglobin (2.27 ± 0.34 vs. 2.25 ± 0.30 g/dL; p-value = 0.587) and hematocrit (2.34 ± 0.94 vs. 2.46 ± 0.28%; p-value = 0.216). Conclusion: Intra-articular administration of tranexamic acid was found to be as effective and safe as intra-venous administration in reducing blood loss in primary total knee arthroplasty. Due to convenience, the use of intra-articular administration of tranexamic acid after primary TKA may be considered in future practice.

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Chowdhary, Rubinah K., Leslie G. Ratkay, Alice J. Canaan, J. Douglas Waterfield, Anna M. Richter, and Julia G. Levy. "Uptake of Verteporfin® by articular tissues following systemic and intra-articular administration." Biopharmaceutics & Drug Disposition 19, no. 6 (September 1998): 395–400. http://dx.doi.org/10.1002/(sici)1099-081x(199809)19:6<395::aid-bdd117>3.0.co;2-9.

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Hayashi, Kei, Alexandria Bourgeois, Daniel Lopez, Brian G. Caserto, Erin Berthelsen, Ursula Krotscheck, Heidi L. Reesink, Sun Young Kim, and David Putnam. "Intra-Articular Administration of a Synthetic Lubricin in Canine Stifles." Veterinary and Comparative Orthopaedics and Traumatology 35, no. 02 (October 1, 2021): 090–95. http://dx.doi.org/10.1055/s-0041-1736189.

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Abstract Objective The aim of this study was to evaluate the functional, systemic, synovial and articular changes after intra-articular administration of a synthetic lubricin within healthy canine stifles. Study Design A prospective randomized blinded placebo-controlled study composed of 10 dogs equally divided into either a treatment group (intra-articular synthetic lubricin injection, n = 5) or control group (saline, n = 5). Clinical (orthopaedic examination, gait observation, gait analysis), biochemical (complete blood count and biochemistry profile) and local tissue outcomes (joint fluid analysis, joint capsule and articular cartilage histopathology) were evaluated over a time period of 3 months. Results No significant differences between the treatment group and control group were identified with regard to baseline patient parameters. No clinically significant orthopaedic examination abnormalities, gait abnormalities, biochemical alterations, joint fluid alterations or histopathological alterations were identified over the course of the study. Conclusion The synthetic lubricin studied herein is both biocompatible and safe for a single administration within the canine stifle joint. Further research is necessary to evaluate the clinical efficacy of the synthetic lubricin in canine osteoarthritic joints.

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Yang, Lin Cheng, Liang-Mei Chen, Ching-Jen Wang, and Hartmut Buerkle. "Postoperative Analgesia by Intra-articular Neostigmine in Patients Undergoing Knee Arthroscopy." Anesthesiology 88, no. 2 (February 1, 1998): 334–39. http://dx.doi.org/10.1097/00000542-199802000-00010.

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Background Recently, the spinal administration of neostigmine was shown to produce a dose-dependent analgesia. However, this analgesia is limited by adverse effects. The purpose of this study was to examine the analgesic action of peripheral muscarinic receptors by administering intra-articular neostigmine after operation in patients undergoing knee arthroscopy. Methods Sixty patients (classified as American Society of Anesthesiologists status I or II) having arthroscopic meniscus repair during general anesthesia were randomized to receive, in a double-blind manner, after operation 125, 250, or 500 microg intra-articular neostigmine; 2 mg intra-articular morphine; or as control groups intra-articular saline or 500 microg neostigmine given subcutaneously (s.c.). Visual analog pain scores (VAS), duration of analgesia as defined by first demand for patient-controlled analgesia by morphine, and subsequent 48-h consumption of morphine were evaluated. Results Intra-articular (500 microg) neostigmine resulted in significant VAS reduction 1 h after injection compared with patients given intra-articular saline and with those given intra-articular morphine. Analgesia lasted longer after 500 microg intra-articular neostigmine (350 +/- 126 min) compared with intra-articular morphine (196 +/- 138 min; P < 0.05) or with the control groups (intra-articular saline, 51 +/- 11 min; s.c. neostigmine, 46 +/- 8 min; P < 0.05). The need for supplementary analgesia was significantly higher in control groups than for patients given intra-articular morphine or 500 microg intra-articular neostigmine. No significant analgesic effects were observed for the two lower doses of intra-articular neostigmine. Among all study groups, no adverse effects were observed. Conclusions Intra-articular injection of the acetylcholinesterase inhibitor neostigmine produced a moderate but significant analgesic effect. Several mechanisms such as the hyperpolarization of neurons, reduction in the release of pronociceptive neurotransmitters, or activation of the nitric oxide-cyclic guanosine monophosphate pathway might mediate this peripheral cholinergic antinociception by elevating endogenous acetylcholine.

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Tani, Yoshiki, Masato Sato, Munetaka Yokoyama, Miyuki Yokoyama, Takumi Takahashi, Eriko Toyoda, Eri Okada, et al. "Intra-articular administration of EP2 enhances the articular cartilage repair in a rabbit model." Journal of Tissue Engineering and Regenerative Medicine 12, no. 11 (September 4, 2018): 2179–87. http://dx.doi.org/10.1002/term.2748.

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Fazeli, Mir Sohail, Louis McIntyre, Yili Huang, and Xavier Chevalier. "Intra-articular placebo effect in the treatment of knee osteoarthritis: a survey of the current clinical evidence." Therapeutic Advances in Musculoskeletal Disease 14 (January 2022): 1759720X2110666. http://dx.doi.org/10.1177/1759720x211066689.

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Knee osteoarthritis (KOA) is a debilitating disease characterized by chronic pain, stiffness, and decreased mobility. Intra-articular injectable therapies show good clinical efficacy in improving symptoms; however, these therapies and their comparators (intra-articular saline) have been associated with a large underlying placebo effect. We aimed to describe the existing evidence on the challenges, hypotheses, and potential solutions to mitigate the intra-articular placebo effect in clinical trials in KOA. A targeted literature review was conducted by searching Embase, MEDLINE®, and CENTRAL using predefined study selection criteria. All eligible studies identified were extracted for relevant data, and results were narratively summarized. Forty-three studies were included following screening. Challenges associated with the intra-articular placebo effect included its ability to mask the comparative efficacy of active treatments in trials ( n = 7 studies), long-lasting effects (up to 6 months; n = 3), and substantial variation of placebo effect sizes across populations ( n = 3). Hypotheses for the mechanism of the placebo effect included aspiration of synovial fluid during administration ( n = 6) and dilution of inflammatory mediators ( n = 2). Factors affecting the placebo effect size were more invasive routes of administration (e.g., injection versus oral; n = 4) and patient expectations ( n = 2). Proposed solutions included the suggestion for readers to weigh the relevance of clinical trial evidence against the presence of large underlying placebo effects ( n = 9), discontinuation of intra-articular saline as an appropriate placebo ( n = 5), and inclusion of ‘no treatment’ or sham injection as a control ( n = 4). The intra-articular placebo effect is a well-documented occurrence in KOA clinical trials, and it is suggested that it be accounted for when designing randomized controlled trials. Awareness and understanding of the intra-articular placebo effect in KOA are required for fair interpretation of clinical trial evidence.

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Chichasova, N. V., and A. M. Lila. "Intra-articular glucocorticoid injection site: best practice guidelines." Meditsinskiy sovet = Medical Council, no. 19 (December 1, 2021): 155–62. http://dx.doi.org/10.21518/2079-701x-2021-19-155-162.

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The article presents modern recommendations for the use of systemic administration of glucocorticoids. It is indicated that there is a clear tendency to minimize the doses and timing of the appointment of systemic glucocorticoids in rheumatoid arthritis, and in seronegative spondyloarthropathies (ankylosing spondylitis, psoriatic arthritis), in accordance with both foreign and domestic recommendations, systemic therapy with glucocorticoids is not carried out. It is emphasized that at the present stage, the role of local administration of glucocorticoids will increase as an effective way to reduce the activity of arthritis in any nosologically form. The mechanisms of action of locally administered glucocorticoids leading to anti-inflammatory and analgesic effects are described. The comparative characteristics of locally administered glucocorticoids with different duration of action according to their effectiveness and safety are presented. Predictors of the effectiveness of local therapy with glucocorticoids are described. The data on the evaluation of the duration of the anti-inflammatory and analgesic effects of various local glucocorticoids, including in comparison with the intra-articular administration of hyaluronic acid preparations, which showed the advantages of betamethasone over triamcinolone acetate, are presented. The differences in the crystal structure of betamethasone and triamcinolone acetate are described. It is indicated that the 2.5-fold smaller size of betamethasone crystals compared to triamcinolone acetate crystals and the absence of betamethasone crystals makes it possible to use betamethasone in the treatment of inflammatory processes in periarticular tissues, as well as in crystalline arthritis (gout, pseudogout). The data on the safety of the use of intra-articular injection of glucocorticoids are presented. It is indicated that the registration in the Russian Federation of a new form of betamethasone in pre-filled syringes makes it even more possible to avoid infectious complications of this type of therapy. Rare cases of complications of local therapy with glucocorticoids are described.

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Toyoda, Eriko, Miki Maehara, Masahiko Watanabe, and Masato Sato. "Candidates for Intra-Articular Administration Therapeutics and Therapies of Osteoarthritis." International Journal of Molecular Sciences 22, no. 7 (March 30, 2021): 3594. http://dx.doi.org/10.3390/ijms22073594.

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Osteoarthritis (OA) of the knee is a disease that significantly decreases the quality of life due to joint deformation and pain caused by degeneration of articular cartilage. Since the degeneration of cartilage is irreversible, intervention from an early stage and control throughout life is important for OA treatment. For the treatment of early OA, the development of a disease-modifying osteoarthritis drug (DMOAD) for intra-articular (IA) injection, which is attracting attention as a point-of-care therapy, is desired. In recent years, the molecular mechanisms involved in OA progression have been clarified while new types of drug development methods based on gene sequences have been established. In addition to conventional chemical compounds and protein therapeutics, the development of DMOAD from the new modalities such as gene therapy and oligonucleotide therapeutics is accelerating. In this review, we have summarized the current status and challenges of DMOAD for IA injection, especially for protein therapeutics, gene therapy, and oligonucleotide therapeutics.

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Cilurzo, Francesco, Francesca Selmin, Paola Minghetti, and Luisa Montanari. "Design of Methylprednisolone Biodegradable Microspheres Intended for Intra-articular Administration." AAPS PharmSciTech 9, no. 4 (November 14, 2008): 1136–42. http://dx.doi.org/10.1208/s12249-008-9158-1.

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Derendorf, Hartmut, Helmut Möllmann, Alf Grüner, Doris Haack, and G. Gyselby. "Pharmacokinetics and pharmacodynamics of glucocorticoid suspensions after intra-articular administration." Clinical Pharmacology and Therapeutics 39, no. 3 (March 1986): 313–17. http://dx.doi.org/10.1038/clpt.1986.45.

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Chen, Jerry Yongqiang, Ngai Nung Lo, Darren Keng Jin Tay, Pak Lin Chin, Shi-Lu Chia, and Seng Jin Yeo. "Intra-Articular Administration of Tranexamic Acid in Total Hip Arthroplasty." Journal of Orthopaedic Surgery 23, no. 2 (August 2015): 213–17. http://dx.doi.org/10.1177/230949901502300221.

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Bradbery, Amanda N., Jessica L. Leatherwood, Brittany L. Silvers, Mattea L. Much, Rafael E. Martinez, and Carolyn E. Arnold. "66 Intra-articular lipopolysaccharide challenge has no long-term effects on inflammation and cartilage metabolism." Journal of Animal Science 98, Supplement_4 (November 3, 2020): 41. http://dx.doi.org/10.1093/jas/skaa278.074.

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Abstract Intra-articular lipopolysaccharide is a common model to induce acute synovitis to investigate the effects of various therapeutic agents or nutraceuticals. The long-term effects of intra-articular lipopolysaccharide use in skeletally mature and immature horses has yet to be investigated; therefore, the objective of this study was to describe long-term effects of single-administration of intra-articular lipopolysaccharide on joint inflammation and cartilage metabolism. To test this objective, both radial carpal joints from 5 stock-type horses never exposed to lipopolysaccharide (CON; n = 10) were compared to radial carpal joints from 17 similar stock-type horses previously exposed to intra-articular lipopolysaccharide (INFL; n = 34). Joints within INFL were further categorized as the joint which received lipopolysaccharide (LPS; n = 17) and contralateral control which received iso-volumetric lactated Ringer’s solution (CONTRA; n = 17). A single synovial fluid sample from each joint was analyzed for prostaglandin E2 (PGE2), collagenase cleavage neopeptide (C2C), carboxypeptide of type II collagen (CPII), and chondroitin sulfate 846 (CS846). All data were analyzed using PROC MIXED of SAS with main effects of treatment (CON, INFL) and joint (CON, LPS, CONTRA). Time post-administration (1.5, 2, 6 yr) and age-at-administration (1, 3, 5, 7 yr) were included in the model within INFL joints (LPS, CONTRA). There was no influence of treatment on any biomarker (P > 0.40). Similarly, inflammation and cartilage metabolism were not different between CON, CONTRA, and LPS joints (P > 0.50). Within INFL, there was no influence of joint, age, or time post-administration for PGE2, CPII, or CS846 (P > 0.10). A joint x time interaction was observed for catabolic C2C (P < 0.01); however, where LPS was less than CONTRA 2 yr post-lipopolysaccharide administration and similarly when lipopolysaccharide was administered at 5 and 7 yr of age (P < 0.01). These data indicate no long-term negative effects for the use of intra-articular lipopolysaccharide as an acute inflammatory model in skeletally mature and immature horses.

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Osaka, Eiji, Yuki Okamura, Yukihiro Yoshida, Masahiko Sugitani, and Yasuaki Tokuhashi. "Intra-articular ectopic ossification associated with denosumab administration for giant cell tumor of bone with intra-articular pathological fracture." Journal of Orthopaedic Science 24, no. 3 (May 2019): 558–62. http://dx.doi.org/10.1016/j.jos.2016.12.026.

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Nuriakhmetov, A. N., I. F. Akhtiamov, D. E. Tsyplakov, A. M. Abdullah, and T. Yu Nuriakhmetova. "Dose-dependent effect of betamethasone on the articular cartilage (experimental study)." Genij Ortopedii 27, no. 1 (February 2021): 80–86. http://dx.doi.org/10.18019/1028-4427-2021-27-1-80-86.

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Introduction Glucocorticosteroid injections have been widely used in clinical practice. Betamethasone is one of the agents of this group of drugs. Its efficacy and therapeutic effect with intra-articular administration are undeniable. There are special instructions on the dosage and frequency of use of the drug but unfortunately there are cases of its wrong administration. There is also an evidence of an adverse effect on cartilage both of the drug itself and its combination with local anesthetics. Aim Evaluation of the results of different weekly intra-articular protocols of betamethasone administration on histological preparations of rabbit knee joints. Methods Histological preparations of the right knee joints of three groups of rabbits were studied: after one, three, and six administrations of betamethason per week and the control intact left knee joints. Results Histological preparations of the control group and the group with a single weekly administration of the drug did not have any changes in the structure of diarthrosis. Dystrophic and necrotic changes affecting all morphological components were observed in the joints of animals that received intra-articular injections of betamethason three times a week (compared to a single injection, the area of dystrophy and necrosis of the cartilage was greater by 10.05 ± 0.75 % (p < 0.05), of subchondral bone by 8.11 ± 0.5 % (p < 0.001), and of synovium by 6.25 ± 0.32 % (p < 0.05). The group with six injections of the drug per week had the most pronounced changes. The area of necrotic changes of the cartilage was greater by 6.39 ± 0.75 % than in the group with three injections per week (p < 0.001), of subchondral bone by 11.18 ± 0.5 % (p < 0.001), of synovium by 6.12 ± 0.32 % (p < 0.001). Discussion Inflammatory cell infiltration of joint structures was absent in all cases. It indicates an aseptic nature of tissue necrosis. Evidence has been obtained between the increase in the frequency of intra-articular injections of betamethasone and the severity of dystrophic and necrotic changes in all morphological components of the joint.

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Abbas, Haidy, Heba A. Gad, Nesrine S. El Sayed, Laila Ahmed Rashed, Mohamed A. Khattab, Ahmad O. Noor, and Mariam Zewail. "Development and Evaluation of Novel Leflunomide SPION Bioemulsomes for the Intra-Articular Treatment of Arthritis." Pharmaceutics 14, no. 10 (September 22, 2022): 2005. http://dx.doi.org/10.3390/pharmaceutics14102005.

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Systemic treatments for rheumatoid arthritis are associated with many side effects. This study aimed to minimize the side effects associated with the systemic administration of leflunomide (LEF) by formulating LEF-loaded emulsomes (EMLs) for intra-articular administration. Additionally, EMLs were loaded with supramagnetic nanoparticles (SPIONs) to enhance joint localization, where a magnet was placed on the joint area after intra-articular administration. Full in vitro characterization, including colloidal characteristics, entrapment efficiency, and in vitro release were conducted besides the in vivo evaluation in rats with adjuvant-induced arthritis. In vivo study included joint diameter measurement, X-ray radiographic analysis, RT-PCR analysis, Western blotting, ELISA for inflammatory markers, and histopathological examination of dissected joints. The particle size and entrapment efficiency of the selected LEF SPION EMLs were 198.2 nm and 83.7%, respectively. The EMLs exhibited sustained release for 24 h. Moreover, in vivo evaluation revealed LEF SPION EMLs to be superior to the LEF suspension, likely due to the increase in LEF solubility by nanoencapsulation that improved the pharmacological effects and the use of SPION that ensured the localization of EMLs in the intra-articular cavity upon administration.

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Karina, Karina, Iis Rosliana, Imam Rosadi, Rachel Schwartz, Siti Sobariah, Irsyah Afini, Tias Widyastuti, Melinda Remelia, Komang Ardi Wahyuningsih, and Jeanne A. Pawitan. "Safety of Technique and Procedure of Stromal Vascular Fraction Therapy: From Liposuction to Cell Administration." Scientifica 2020 (July 6, 2020): 1–11. http://dx.doi.org/10.1155/2020/2863624.

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Background. Stromal vascular fraction (SVF) therapy has been performed over the past six years to treat 421 patients by our group in five clinical centers. Autologous SVF, which is a substance containing stem cells, was isolated from lipoaspirate, mixed with platelet-rich plasma (PRP), and administered to patients with degenerative diseases, autoimmune diseases, trauma, aging, and other diseases with unknown etiology. This study aimed to determine the safety of SVF and PRP that were given through infusion, spinal, and intra-articular injection. Methods. The lipoaspirate was treated with a tissue-dissociating enzyme, and then, through centrifugation, SVF was isolated. In addition, blood was drawn from each patient, and PRP was isolated. Autologous PRP and SVF were administered to all subjects by intravenous (IV) injection. A minority group within the population received an additional spinal or intra-articular injection. The type of intervention was determined by each disease evaluation. The cell doses and adverse events for each patient were documented and analyzed. Results. Cell dose that was considered to be safe was less than 10 billion SVF cells in 250 cc of normal saline, for IV injection, and less than 1 billion SVF, for intra-articular and spinal injection. Adverse events were not severe and were treated successfully. Any observed adverse events were identified as a result of spinal or intra-articular injections and were not related to SVF or PRP. Conclusions. Our results showed that administration of high dose of SVF until 10 billion cells in a majority of 421 patients through infusion, spinal, and intra-articular injection was feasible without causing major adverse events and should be further investigated in well-designed phase I-II clinical trial to address the safety and efficacy of therapy.

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Kumar, Ch Anil, and Kalyan S. "A Randomized Controlled Trial on Assessment of Analgesia on Using Magnesium Sulphate by Different Routes in Patients Undergoing Arthroscopy of Knee under Spinal Anaesthesia." Journal of Evolution of Medical and Dental Sciences 11, no. 1 (January 25, 2022): 93–97. http://dx.doi.org/10.14260/jemds/2022/18.

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BACKGROUND Adequate pain management has a great importance for smooth postoperative recovery, early hospital discharge and early rehabilitation. In this study, we compare the analgesic effect and possible side effects of different routes of magnesium sulphate administration in cases of spinal anaesthesia for knee arthroscopy. METHODS This is an experimental prospective randomized control study. 196 patients undergoing knee arthroscopy were divided into 4 groups (49 each): Group A: Given bupivacaine intrathecally during spinal anaesthesia. Group B: Given magnesium sulphate 50 mg with bupivacaine intrathecally. Group C: Given magnesium sulphate IV 10 min after intrathecal injection (30 mg/kg MgSo4). Group D: Given magnesium sulphate intra-articular route, 10 min before the end of surgery (800 mgSo4 diluted in 12 ml normal saline (0.9 % NaCl). Operative time in minutes, VAS at rest and after procedure, time lapse before first analgesic dose after surgery, total dose of rescue analgesics used, pulse rate, mean arterial pressure and side effects were observed and analysed. RESULTS In regards to the lapse of time between end of surgery and first rescue analgesic given, total doses of tramadol used during the 24 hours after the procedure were significantly better in patients given intra-articular magnesium sulphate than other groups (P = 0.001). Patients of Group C who received IV magnesium sulphate were significantly better than patients who were given intrathecal magnesium sulphate in relation to time taken from end of surgery until first analgesic dose. VAS at rest and during the period of first 24 hours followed by surgery was statistically significant in patients who received intra-articular magnesium sulphate (p- 0.001). CONCLUSIONS Intra-articular administration of magnesium sulphate was observed to be superior to other routes of administration or not using at all. Next to intra-articular route, intravenous magnesium sulphate was found to be superior to intrathecal route in providing post operative analgesia in arthroscopy patients. KEY WORDS Analgesia, Knee Arthroscopy, Pain, Magnesium Sulphate, Intrathecal, Intra-articular

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Sikora, Maciej, Barbara Czerwińska-Niezabitowska, Maciej Adam Chęciński, Marcin Sielski, and Dariusz Chlubek. "Short-Term Effects of Intra-Articular Hyaluronic Acid Administration in Patients with Temporomandibular Joint Disorders." Journal of Clinical Medicine 9, no. 6 (June 5, 2020): 1749. http://dx.doi.org/10.3390/jcm9061749.

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The study described in this paper was conducted to assess the short-term outcomes of intra-articular administration of hyaluronic acid in patients with symptoms of temporomandibular joint disorders. A group of 40 patients suffering from temporomandibular joint disorders underwent a series of hyaluronic acid intra-articular injections. Questionnaires and clinical examinations were conducted to assess stress exposure of the subjects and to evaluate short-term treatment outcomes, i.e., reducing joint and muscle pain and increasing the mobility of the mandible. A weak positive correlation between stress exposure and pain was observed. As a result of treatment, 61% of subjects revealed a total reduction of muscle pain, while joint pain completely resolved in 88% of patients. Mandibular mobility increased by 11%, 31%, 9%, and 11% regarding opening, protrusive, and lateral right and left movements, respectively. The study confirms the short-term effectiveness of intra-articular administration of hyaluronic acid on reducing joint and muscle pain in patients with articular disc displacement. The treatment positively affected the mobility of the mandible in all directions. The verification of late treatment effects of hyaluronic acid viscosupplementation requires the continuation of the research.

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Polis, I., F. Verschooten, Van Ryssen, and D. Van Vynckt. "A review of the human and veterinary literature on local anaesthetics and their intraarticular use." Veterinary and Comparative Orthopaedics and Traumatology 23, no. 04 (2010): 225–30. http://dx.doi.org/10.3415/vcot-09-10-0107.

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SummaryLameness in dogs is often a diagnostic challenge. In many cases it is difficult to determine the exact localisation of lameness because of the absence of palpable changes, or because of unreliable pain response due to high pain tolerance, stress or aggression of the dog. In horses and humans, intra-articular administration of local anaesthetics is commonly used for diagnostic purposes. In this review, information from human and veterinary studies on different local anaesthetic agents and their application for diagnostic intra-articular anaesthesia is given. Based on this information, a protocol for diagnostic intra-articular anaesthesia in the dog can be developed and evaluated in future studies.

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Wenz, Wolfram, Christian Hornung, Christopher Cramer, Malte Schroeder, and Michael Hoffmann. "Effect of Glucosamine Sulfate on Osteoarthritis in the Cruciate-Deficient Canine Model of Osteoarthritis." CARTILAGE 8, no. 2 (June 23, 2016): 173–79. http://dx.doi.org/10.1177/1947603516638898.

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Objective Osteoarthritis (OA) is a major cause of musculoskeletal pain and disability worldwide. The investigation of disease-modifying treatment options for OA has become an important aspect of orthopedic care. To assess the effect of intra-articular and oral glucosamine sulfate (GS) versus placebo on osteoarthritis in a canine model. Materials In this randomized, placebo-controlled, double-blinded study, OA was induced by anterior cruciate ligament transection (ACLT) according to the Pond-Nuki model in 32 canines. All canines were allocated into 4 treatment subgroups with treatment administered for 8 weeks: GS (400 mg) intra-articular, placebo intra-articular, GS (200 mg/kg body weight) oral, and placebo oral. The contralateral nonoperated stifle (knee) served as control. After 8 weeks, the medial and lateral femoral condyles, the medial and lateral tibial plateau and patella were histologically examined and anatomic changes quantified by light microscopy using the modified Mankin score. Results After 8 weeks, mean Mankin score values significantly ( P < 0.002) decreased in the intra-articular GS group (8.1; range 7.9-8.8) compared with the intra-articular placebo group (13.9; range 11.6-15.9) and again significantly ( P < 0.002) in the oral GS group (12.1; range 9.9-12.7) compared with the oral placebo group (15.1; range 12.5-17.0). Mean Mankin score values were significantly ( P < 0.002) lower in the intra-articular GS group compared with the oral GS group. Conclusion Both, intra-articular and oral administered GS significantly reduced histological signs of OA in the Pond-Nuki model, with the intra-articular application being more effective compared to oral administration.

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Karaaslan, Fatih, Sinan Karaoğlu, and Musa Uğur Mermerkaya. "Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction." Orthopaedic Journal of Sports Medicine 2, no. 11_suppl3 (November 1, 2014): 2325967114S0013. http://dx.doi.org/10.1177/2325967114s00136.

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Objectives: A significant proportion of surgeons use intra-articular drains after arthroscopic anterior cruciate ligament (ACL) reconstruction. Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction. The purpose of the study was to evaluate the effect of tranexamic acid (TXA) administration to minimize pain and stiffness of knee joint by reducing haemarthrosis. Methods: The study enrolled 123 patients who underwent arthroscopic anterior cruciate ligament reconstruction in a prospective, randomized, double-blind study. The patients who were randomized into the TXA group (71 patients) received both intravenous and intra-articular TXA. The control group (52 patients) did not receive TXA. The anesthetist, surgeon, and observer were blinded to the study group (double-blinded). TXA was administered as a bolus dose of 15 mg/kg 10 minutes before the inflation of the tourniquet on the first side. This was followed by continued intra-articular administration of 3 g at 10 minutes before the deflation of the tourniquet. Intravenous infusion of 10 mg/kg/h was continued for the next 3 hours. Equal volumes of placebo were administered at the same rate and by the same route. We measured volume of drained blood 48 hours postoperatively. Results: The mean (± SD) postoperative volume of blood loss from the drain in the TXA and control groups was 100.6 ± 72mL and 164.3 ± 75mL ml, respectively. The difference between the two groups was significant (p < 0.005). Conclusion: This prospective randomized study showed that during arthroscopic anterior cruciate ligament reconstruction, TXA reduced blood loss and helped to reduce haemarthrosis amount and frequency with negligible side effects. With regard to the administration route, combined intravenous–intra-articular administration of TXA significantly reduces blood loss and the need for puncturing associated with arthroscopic anterior cruciate ligament reconstruction without enhancing the risk of deepssssssahrombosis.

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Olyunin, Yu A., and I. N. Schendrigin. "Intra-articular injections in the treatment of osteoarthritis." Modern Rheumatology Journal 16, no. 1 (February 19, 2022): 97–102. http://dx.doi.org/10.14412/1996-7012-2022-1-97-102.

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Local methods are widely used in the treatment of osteoarthritis (OA) and play a significant role in the complex therapy of this disease. A special place among them belongs to intra-articular (i/a) administration of drugs. The most widely used for this purpose are glucocorticoids (GC) and hyaluronic acid (HA) drugs. When comparing the effectiveness of these drugs, it was shown that during the 1st month, HA had more favorable results, after 3 months the results did not differ significantly, and after 6 months, the effectiveness of HA was higher. Some authors believe that the optimal result can be obtained with the combined use of HA and GC.The efficacy and tolerability of HA drugs in patients with OA have been studied in numerous randomized controlled trials (RCTs), and the data obtained in these studies have been summarized in a number of meta-analyses. At the same time, both in RCTs and in meta-analyses, the results of such treatment were assessed differently. However, when summarizing the materials of various meta-analyses within the framework of a systematic review, it was shown that i/a injections of HA are an effective and safe method of local treatment of OA. However, there are no generally accepted recommendations for the use of HA in the treatment of OA, and the question of their administration in each case is decided individually, taking into account the history, clinical picture, OA phenotype, and tolerability of therapy. The Russian Association of Rheumatologists recommends the use of i/a HA injections in knee OA with synovitis and the use of HA injections to reduce pain and improve joint function.

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Parlak, K., and M. Arican. "Effect of intra-articular administration of autologous PRP and activated PRP on inflammatory mediators in dogs with osteoarthritis." Veterinární Medicína 65, No. 2 (February 28, 2020): 62–70. http://dx.doi.org/10.17221/36/2019-vetmed.

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The aim of this study was to investigate the effects of the intra-articular use of platelet rich plasma (PRP) and bio-physically activated PRP (BPRP) on the inflammatory mediators for the treatment of osteoarthritis in dogs. The animals included in this study were 36 mix breed dogs diagnosed with osteoarthritis in the stifle as a result of the clinical and radiological examinations. The dogs were randomly divided into three groups: PRP (platelet-rich plasma), BPRP (biophysically activated platelet-rich plasma) and control (given 0.9% isotonic saline). These three main groups were each further divided into two groups as single and double according to the number of intraarticular administrations. Joint fluid analyses, a clinical examination (Hudson Visual Analog Scale and Canine Brief Pain Inventory Tests) radiographic and ultrasonographic examinations were performed on days 1, 15, 30, 60, and 90 for each group. Genesis System 2 branded and BPRP preparation kits were used in this study. An ELISA method was used to measure the cytokines in charge of the inflammatory mediation (IL-1β, IL-6, IL-10, TNF-α) in the synovial fluid samples. The records obtained from the walking and pain rating tests were subjected to a statistical analysis program and a Mann-Whitney U test was performed. The results of the ELISA were evaluated by a Tukey test. There was a significant difference between the single and double groups of the PRP administration on days 60 and 90 (P < 0.05) in the walking and pain scores. The double groups of the PRP had better results than the single groups. There was a significant difference between the single groups of the PRP and BPRP for the IL-10 on the 30<sup>th</sup> day (P < 0.05). In the single application groups, the BPRP was better than the PRP on day 30 in the IL-10 measurements. In the comparison of the single and double administration groups, there was significant difference between the single and double groups of the BPRP on day 90 (P < 0.05). The double groups of the BPRP had better results than the single groups. In addition, the biophysically activated PRP was found to be superior to the PRP for the IL-10 content. In conclusion, the efficacy of the PRP and BPRP was related to the degree of the osteoarthritis (OA). Especially the success rate in the acute OA patients was higher due to the anti-inflammatory activity of the BPRP. Moreover, the double administration groups gave more positive results than the single administration groups.

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Panina, Elena. "Intra-articular administration of glucocorticosteroids in the practice of a rheumatologist." Clinical Medicine and Pharmacology 6, no. 4 (February 2, 2021): 23–35. http://dx.doi.org/10.12737/2409-3750-2021-6-4-23-35.

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Intra-articular and periarticular use of drugs for the purpose of relieving inflammation of the synovial membrane or periarthritis is an integral part of the complex pathogenetic treatment of joint diseases. Effectiveness of local therapy with glucocorticosteroids (GCS )there is no doubt and depends on a number of factors, which should include the correct assessment of indications and contraindications, the correct choice of the drug, its dosage and technique of manipulation. The use of this method can significantly reduce the time of industrial and/or household disability in this extensive category of patients.However, the doctor's ignorance or disregard of the mandatory conditions and requirements for performing this minor surgical manipulation can lead to undesirable, including severe, discrediting consequences of the valuable method. Postgraduate training of doctors helps to solve the problem of non-professional approach to the appointment and conduct of intra-articular and periarticular manipulations using GCS.

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Moretti, Antimo, Marco Paoletta, Sara Liguori, Walter Ilardi, Francesco Snichelotto, Giuseppe Toro, Francesca Gimigliano, and Giovanni Iolascon. "The Rationale for the Intra-Articular Administration of Clodronate in Osteoarthritis." International Journal of Molecular Sciences 22, no. 5 (March 7, 2021): 2693. http://dx.doi.org/10.3390/ijms22052693.

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Background: Several pharmacological therapeutic approaches have been proposed to manage osteoarthritis (OA), including intra-articular (IA) injections. Although the discovery of clodronate, a bisphosphonate, dates back to the 1960s and the effects of its IA administration have been investigated for decades in animal models, mechanisms of action of this drug are not quite clear, particularly in OA. This scoping review is an overview of the biological as well as the clinical role of clodronic acid in OA. Method: A scoping review based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model was performed to characterize the mechanisms of action of IA clodronate in OA and to evaluate its efficacy from a clinical point of view. Results: Several effects of clodronate have been observed in animal models of OA, including depletion of synovial lining cells that results in reduced production of chemokines (IL-1, TNF- α), growth factors (TGF-β, BMP 2/4), and metalloproteases (MMP 2/3/9); prevention of cartilage damage, synovial hyperplasia, and proteoglycans loss; reduction in joint inflammation, joint swelling, and osteophyte formation. From a clinical perspective, patients with knee OA treated with IA clodronate experienced improvements in pain and joint mobility. Conclusion: Clodronate appears to have different mechanisms of action interfering with the pathogenic processes contributing to OA development and progression. This intervention demonstrated positive effects for patients affected by knee OA.

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Harris, Edward D. "Glucocorticoid therapy in rheumatoid arthritis: intra-articular injections versus systemic administration." Nature Clinical Practice Rheumatology 2, no. 4 (April 2006): 184–85. http://dx.doi.org/10.1038/ncprheum0160.

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Vela-Anero, Á., T. Hermida-Gomez, P. Filgueira-Fernández, L. Gato-Calvo, E. F. Burguera, R. Meijide-Failde, and F. J. Blanco. "Intra-articular administration of hydrogen sulphide ameliorates severity of experimental osteoarthritis." Osteoarthritis and Cartilage 26 (April 2018): S287—S288. http://dx.doi.org/10.1016/j.joca.2018.02.579.

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Burstein, Haim, Kurt Lustig, and Ziv Sandalon. "983. Repeat Intra-Articular Administration of AAV2 Vectors to Rat Joints." Molecular Therapy 13 (2006): S378. http://dx.doi.org/10.1016/j.ymthe.2006.08.1076.

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Sturgess, J. E., D. H. Long, and D. W. Thomas. "The use of salvaged blood after intra-articular administration of bupivacaine." Anaesthesia 57, no. 10 (October 2002): 1047. http://dx.doi.org/10.1046/j.1365-2044.2002.28935.x.

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Magri, Giulia, Francesca Selmin, Francesco Cilurzo, and Nikoletta Fotaki. "Biorelevant release testing of biodegradable microspheres intended for intra-articular administration." European Journal of Pharmaceutics and Biopharmaceutics 139 (June 2019): 115–22. http://dx.doi.org/10.1016/j.ejpb.2019.03.019.

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Russo, E., N. Gaglianone, S. Baldassari, B. Parodi, I. Croce, A. M. Bassi, S. Vernazza, and G. Caviglioli. "Chitosan-clodronate nanoparticles loaded in poloxamer gel for intra-articular administration." Colloids and Surfaces B: Biointerfaces 143 (July 2016): 88–96. http://dx.doi.org/10.1016/j.colsurfb.2016.03.028.

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Voog, Ülle, Per Alstergren, Edvitar Leibur, Riina Kallikorm, and Sigvard Kopp. "Influence of serotonin on the analgesic effect of granisetron on temporomandibular joint arthritis." Mediators of Inflammation 13, no. 5-6 (2004): 373–76. http://dx.doi.org/10.1080/09629350400014123.

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THE influence of circulating serotonin (5-HT) on the effects of intra-articular administration of granisetron on temporomandibular joint (TMJ) pain was investigated in 11 patients with chronic polyarthritides. An analgesic effect superior to placebo has been shown previously.The change in TMJ movement pain intensity was negatively correlated to circulating 5-HT; that is, the higher the 5-HT before injection, the greater the reduction of pain intensity. The resting pain intensity reduction was not related to 5-HT.In conclusion, this study indicates a stronger short-term analgesic effect on TMJ movement pain by intra-articular administration of the 5-HT3receptor antagonist granisetron in patients with high levels of circulating 5-HT.

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Svintsitskaya, I. S., and K. Yu Volkov. "Smart addition is multiplication: a review concerning combined use of hyaluronic acid and polynucleotides for intra-articular administration in osteoarthritis." Russian Medical Inquiry 6, no. 4 (2022): 182–86. http://dx.doi.org/10.32364/2587-6821-2022-6-4-182-186.

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The article presents an overview of modern methods to the treatment of osteoarthritis (OA). It is focused on intra-articular injections of hyaluronic acid and polynucleotides (PNs) of natural origin. Hyaluronic acid is a natural component of connective tissue that has the ability to restore the viscoelastic properties of synovial fluid. Besides, it also has anti-apoptotic, anti-inflammatory, anti-angiogenic and antifibrotic characteristics. PNs are natural macromolecules derived from DNA. They have trophic activity and promote cell growth and collagen production, as has been shown in preclinical and clinical studies concerning cartilage regeneration. When injected into the joint cavity, PNs are subjected to enzymatic cleavage with the release of nucleosides, nucleotides and nitrogenous bases, thereby, providing long-term moisturizing and viscoelastic properties of synovial fluid. The efficacy of a combination of hyaluronic acid preparations with PNs for intra-articular administration for the treatment of knee OA has been studied. It has been established that the combined therapy with PNs and hyaluronic acid leads to the development of a more persistent therapeutic effect for 2 years after the treatment course versus with hyaluronic acid monotherapy. KEYWORDS: osteoarthritis, synovial fluid, viscoelastic properties, synovial fluid substitute, intra-articular injections, hyaluronic acid, polynucleotides FOR CITATION: Svintsitskaya I.S., Volkov K.Yu. Smart addition is multiplication: a review concerning combined use of hyaluronic acid and polynucleotides for intra-articular administration in osteoarthritis. Russian Medical Inquiry. 2022;6(4):182–186 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-182-186

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Shin, Youngjoo, Jongkeun Seon, Eunkyoo Song, Donghyun Lee, and Jehyoung Yeo. "Combined administration better than intravenous or intra-articular tranexamic acid administration – a randomized control study." Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology 9 (July 2017): 64. http://dx.doi.org/10.1016/j.asmart.2017.05.132.

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Öztürk, Alpaslan, Yavuz Akalin, Nazan Çevik, Özgür Avcı, Oğuz Çetin, and Harun Sağlicak. "Tranexamic acid use in simultaneous bilateral total knee arthroplasty : a comparison of intravenous and intra-articular applications, which is more effective?" Acta Orthopaedica Belgica 87, no. 3 (September 30, 2021): 479–86. http://dx.doi.org/10.52628/87.3.13.

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Patients applied with simultaneous bilateral total knee arthroplasty (SBTKA) with the administration of intravenous or intra-articular tranexamic acid (TXA) were compared in respect of blood loss and the need for allogenic blood transfusion. Of a total 53 patients applied with SBTKA, 32(60%) were administered intravenous TXA and 21(40%) intra-articular TXA. The patients were evaluated in respect of age, gender, height, weight, body mass index (BMI), body blood volume, preoperative and 1,2,3 and 4 days postoperative levels of hemoglobin (Hb) and hematocrit (Htc) and the change in Hb levels, estimated blood loss, mean actual blood loss, the need for allogenic blood transfusion (ABT) and the use or not of a drain. No difference was determined between the intravenous and intra-articular groups in respect of mean age, gender, height, weight, and body blood volume. No difference was determined between the groups in preoperative and postoperative mean Hb and Hct values, the reduction in mean Hb postoperatively, estimated blood loss, or the need for ABT. No deep vein thrombosis or pulmonary embolism was determined in any patient. In the application of SBTKA, TXA can be safely administered by the intravenous or intra-articular route to reduce the need for ABT. The results of this study determined no difference in efficacy between the routes of application. For patients with a risk of intravenous use, intra-articular application can be preferred.

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Guida, Francesca, Monica Rocco, Livio Luongo, Pietro Persiani, Maria Chiara Vulpiani, Sveva Maria Nusca, Sabatino Maione, and Flaminia Coluzzi. "Targeting Neuroinflammation in Osteoarthritis with Intra-Articular Adelmidrol." Biomolecules 12, no. 10 (October 11, 2022): 1453. http://dx.doi.org/10.3390/biom12101453.

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Neuroinflammation is an emerging therapeutic target in chronic degenerative and autoimmune diseases, such as osteoarthritis (OA) and rheumatoid arthritis. Mast cells (MCs) play a key role in the homeostasis of joints and the activation of MCs induces the release of a huge number of mediators, which fuel the fire of neuroinflammation. Particularly, synovial MCs release substances which accelerate the degradation of the extra-cellular matrix causing morphological joint changes and cartilage damage and inducing the proliferation of synovial fibroblasts, angiogenesis, and the sprouting of sensory nerve fibers, which mediate chronic pain. Palmitoylethanolamide (PEA) is a well-known MCs modulator, but in osteoarthritic joints, its levels are significantly reduced. Adelmidrol, a synthetic derivate of azelaic acid belonging to the ALIAmides family, is a PEA enhancer. Preclinical and clinical investigations showed that the intra-articular administration of Adelmidrol significantly reduced MC infiltration, pro-inflammatory cytokine release, and cartilage degeneration. The combination of 1% high molecular weight hyaluronic acid and 2% Adelmidrol has been effectively used for knee osteoarthritis and, a significant improvement in analgesia and functionality has been recorded.

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Filatova, Yulia S., and Igor N. Soloviev. "Hyaluronic acid in the treatment of osteoarthritis of various localization: A review." Terapevticheskii arkhiv 94, no. 8 (October 12, 2022): 1014–19. http://dx.doi.org/10.26442/00403660.2022.08.201790.

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The article discusses the treatment of osteoarthritis (OA), the prevalence of which is high, and according to some forecasts it will increase by 50% in the next 20 years. The authors emphasize the high comorbidity among patients suffering from OA and high cardiovascular and gastrointestinal risks with frequent use of NSAIDs, the volume of consumption of which is constantly increasing. Discussing recommendations for the treatment of patients with OA, the article focuses on the use of hyaluronic acid (HA) preparations in the treatment of OA. The mechanisms of anti-inflammatory and chondroprotective actions of HA in the joint, its effect on cartilage and synovial membrane are discussed. Attention is drawn to the fact that, despite more than 30 years of experience in the effective use of HA preparations in the treatment of OA, this procedure is still a subject of controversy among international professional communities. The article presents data from meta-analyses and systematic reviews confirming the effectiveness of the use of intra-articular management of HA preparations in OA of various localization (knee joints, hip joints, hand joints). In conclusion, the recommendations of the technical expert group established at the International Symposium on Intra-Articular Treatment are given to determine the criteria for the successful administration of HA in OA of various localizations, as well as predictors of success and non-success of therapy with HA drugs. The experts identified indications, contraindications for intra-articular administration of HA preparations, as well as conditions associated with an increased risk of therapy failure. In conclusion, the authors draw conclusions about the importance of using HA preparations for intra-articular administration for the treatment of OA, starting from the early stages, following the recommendations of experts.

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García-Couce, Jomarien, Timo Schomann, Chih Kit Chung, Ivo Que, Carla Jorquera-Cordero Gastón Fuentes, Amisel Almirall, Alan Chan, and Luis J. Cruz. "Thermosensitive Injectable Hydrogels for Intra-Articular Delivery of Etanercept for the Treatment of Osteoarthritis." Gels 8, no. 8 (August 5, 2022): 488. http://dx.doi.org/10.3390/gels8080488.

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The intra-articular administration of drugs has attracted great interest in recent decades for the treatment of osteoarthritis. The use of modified drugs has also attracted interest in recent years because their intra-articular administration has demonstrated encouraging results. The objective of this work was to prepare injectable-thermosensitive hydrogels for the intra-articular administration of Etanercept (ETA), an inhibitor of tumor necrosis factor-α. Hydrogels were prepared from the physical mixture of chitosan and Pluronic F127 with β-glycerolphosphate (BGP). Adding β-glycerolphosphate to the system reduced the gelation time and also modified the morphology of the resulting material. In vitro studies were carried out to determine the cytocompatibility of the prepared hydrogels for the human chondrocyte line C28/I2. The in vitro release study showed that the incorporation of BGP into the system markedly modified the release of ETA. In the in vivo studies, it was verified that the hydrogels remained inside the implantation site in the joint until the end of the study. Furthermore, ETA was highly concentrated in the blood of the study mice 48 h after the loaded material was injected. Histological investigation of osteoarthritic knees showed that the material promotes cartilage recovery in osteoarthritic mice. The results demonstrate the potential of ETA-loaded injectable hydrogels for the localized treatment of joints.

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47

Thakkar, Hetal, Rakesh Kumar Sharma, and R. S. R. Murthy. "Enhanced Retention of Celecoxib-Loaded Solid Lipid??Nanoparticles after Intra-Articular Administration." Drugs in R & D 8, no. 5 (2007): 275–85. http://dx.doi.org/10.2165/00126839-200708050-00002.

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Saravanan, Muniyandy, Kesavan Bhaskar, Gomathinayagam Maharajan, and Kalathil Sadasivan Pillai. "Development of gelatin microspheres loaded with diclofenac sodium for intra-articular administration." Journal of Drug Targeting 19, no. 2 (April 12, 2010): 96–103. http://dx.doi.org/10.3109/10611861003733979.

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Knych, H. K., J. A. Blea, R. M. Arthur, L. R. Overly, and C. W. McIlwraith. "Clearance of corticosteroids following intra-articular administration of clinical doses to racehorses." Equine Veterinary Education 28, no. 3 (January 13, 2016): 140–44. http://dx.doi.org/10.1111/eve.12532.

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Yovandich, Jason, Bert O'malley, Michael Sikes, and Fred D. Ledley. "Gene Transfer to Synovial Cells by Intra-Articular Administration of Plasmid DNA." Human Gene Therapy 6, no. 5 (May 1995): 603–10. http://dx.doi.org/10.1089/hum.1995.6.5-603.

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