HYALURONIC ACID is a naturally occurring polysaccharide in the joint synovial fluid, which acts as a lubricant and shock absorber. An injectable form of hyaluronic acid (injected once weekly for 3 to 4 weeks, for a total of 3 to 4 injections) is useful for the treatment of pain associated with joint osteoarthritis as elastoviscous properties of the synovial fluid in the knee joint becomes diminished in osteoarthritis resulting in diminution of shock absorption and joint protection. In the long term, the restoration of the joint mobility due to relief of pain triggers a sequence of events, which restores the trans-synovial flow and subsequently the metabolic and rheological homeostasis of the joint and benefits are documented before as well as after the arthroscopic surgery. Trials have indicated that compounds with hyaluronic acid result in statistically significant improvement in reducing pain and increasing levels of mobility in the majority of individuals treated with mild to moderate osteoarthritis, as compared with placebo, and may even slow down deterioration of joints and thereby prolong the need of arthroplasty even in older patients with severe osteoarthritis. Hyaluronic acid injection with modulated physiotherapy and muscle strengthening exercises can be an answer to the people with arthritis to prolong the disease progression.

In the long term, the restoration of the joint mobility due to relief of pain triggers a sequence of events, which restores the trans-synovial flow and subsequently the metabolic and rheological homeostasis of the joint and benefits are documented before as well as after arthroscopic surgery. Trials have indicated that compounds with hyaluronic acid result in statistically significant improvement in reducing pain and increasing levels of mobility in the majority of individuals treated with mild to moderate osteoarthritis, as compared with placebo, and may even slow down deterioration of joints and thereby prolong the need of arthroplasty even in older patients with severe osteoarthritis.

In recent years it has been developed High Purity Hyaluronan (Highly Purified Hyaluronan, HPH). It biotechnology products with complete purity, produced by cell cultures. In our experience in early stages of knee joint degeneration, good results can be achieved with intra-articular injections of high density (82.8 mg) HA (PROmovia, SIFRA, Pistoia, Italy).