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. 2018 Jan 3:11:1179544117751622.
doi: 10.1177/1179544117751622. eCollection 2018.

Rheological Properties of Commercially Available Hyaluronic Acid Products in the United States for the Treatment of Osteoarthritis Knee Pain

Mathew Nicholls  1 , Ajay Manjoo  2 , Peter Shaw  3 , Faizan Niazi  3 , Jeffrey Rosen  4
Affiliations

Rheological Properties of Commercially Available Hyaluronic Acid Products in the United States for the Treatment of Osteoarthritis Knee Pain

Mathew Nicholls et al. Clin Med Insights Arthritis Musculoskelet Disord. .

Abstract

Objective: The inconsistent results within the current literature regarding the efficacy of intra-articular-hyaluronic acid (IA-HA) for the treatment of knee osteoarthritis (OA) have been suggested to be due to intrinsic differences between individual HA products. The purpose of this investigation is to define the rheological differences between currently available HA products in the United States at the time of this study for the treatment of knee OA, which will help elaborate on the appropriateness of classifying HA products as a class opposed to as individual agents.

Methods: The rheological parameters for Euflexxa, Orthovisc, Supartz, Monovisc, Synvisc, Synvisc-One, Gel-One, and Hyalgan were obtained with a TA AR 2000 EX Rheometer with a cone-plate geometry (40-mm plate diameter and a 2° cone angle) at room temperature.

Results: The bulk rheological parameters of the different products suggest molecular structures traversing the range of dilute solution (Hyalgan, Supartz), semidilute solution (Euflexxa, Orthovisc), entangled solutions (Monovisc, Synvisc, Synvisc-One), and even gel-like (Gel-One) behavior.

Conclusions: Due to the differences in rheological properties between IA-HA products, the universal assessment of these products as a class may not be appropriate. Instead, it may be more appropriate to assess each product individually. Future research should aim to link these differences in rheological properties to the differences in clinical efficacy seen across these IA-HA products.

Keywords: Hyaluronic acid; knee; osteoarthritis; rheological properties; viscosupplementation.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.N. serves on advisory boards for Ferring. A.M. discloses no conflicts of interest. F.N. and P.S. are paid employees of Ferring Pharmaceuticals Inc. J.R. is the speaker trainer for Ferring Pharmaceuticals Inc.

Figures

Figure 1.
Figure 1.
Rheometer diagram.
Figure 2.
Figure 2.
Zero shear rate viscosity (η0.1) of different viscosupplements.
Figure 3.
Figure 3.
Shear rate viscosity (η250) of different viscosupplements.
Figure 4.
Figure 4.
Viscosity shear rate ratio (η0.1/η250) of different viscosupplements.
See this image and copyright information in PMC

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