Effects of Oral Hyaluronic Acid Administration in Dogs Following Tibial Tuberosity Advancement Surgery for Cranial Cruciate Ligament Injury

Abstract

Hyaluronic acid (HA) intraarticular injection is used in the management of osteoarthritis in veterinary medicine. However, HA oral administration is less common given the scarce currently available scientific evidence. This study was aimed at evaluating the effects of oral HA administration on synovial fluid concentrations of several selected biomarkers in dogs with cranial cruciate ligament (CCL) injury operated on using the tibial tuberosity advancement (TTA) technique. Fifty-five dogs were included in this prospective, randomized, double-blind, clinical study; they were randomly assigned to receive either a placebo (group A; n = 25) or HA (group B; n = 30) orally for 10 weeks. Synovial fluid samples were obtained before surgery, and at 10 weeks postoperatively to measure concentrations of HA, haptoglobin, nitric oxide, and paraoxonase-1. After 10 weeks, group HA showed a significant increase in HA concentration (p = 0.0016) and a significant decrease in PON-1 concentration (p = 0.011) compared to baseline. In conclusion, post-op oral HA administration in canine patients with CCL injury leads to improvements in osteoarthritis biomarkers, namely higher synovial fluid HA concentrations and reduced synovial fluid paraoxonase-1 concentrations. These findings support the bioavailability of orally-administered HA and its usefulness in improving biomarkers of osteoarthritis.

Surgical treatment of cranial cruciate ligament disease in dogs using Tibial Plateau Leveling Osteotomy or Tibial Tuberosity Advancement–A systematic review with a meta-analytic approach

“…Random sequence generation and allocation concealment were evaluated to assess selection bias. Twelve studies were considered to produce low risk of selection bias ( Table 1 ) regarding random sequence generation and allocation concealment (as they used adequate methods to generate the allocation sequence: these studies assign subjects via computer-assisted lists ( 31 , 36 , 37 , 39 , 48 , 54 , 65 , 66 ) such as Excel or commonly available online tools, via coin toss ( 35 , 38 , 44 ) or by referring to a random number table ( 40 ).…”

“…They were therefore considered to have a low risk of performance and detection bias ( Table 1 ). Some studies described blinding to some extent ( 37 , 65 ) or it was not possible to blind all personnel and owners to all treatments ( 31 , 32 ).…”

“…Also, reported outcomes which might be different from the true outcome as potential follow-up losses cannot be identified. Studies with unclear financial support ( 62 , 63 , 83 , 87 , 96 , 97 ), support of financial nature, consultant activity, company collaboration or speaker engagement ( 31 – 33 , 36 – 38 , 40 , 44 , 46 , 47 , 56 , 60 , 65 , 69 , 71 , 72 , 76 , 98 ) (e.g., financial funding) or other potential conflicts of interests ( 39 , 50 , 51 , 54 , 57 , 59 , 67 , 73 , 80 , 92 ) led to an unclear risk of bias.…”

“…Pain was assessed in six TPLO and five TTA studies with a total of 382 surgeries (169 TPLO, 213 TTA). Several validated instruments and their modifications were used to classify pain on a scale ( 36 – 39 , 43 , 60 , 65 , 66 ) while other authors created their own scale in expressing pain in grades ( 31 , 100 ) or as absent or present ( 99 ). High quality of evidence was provided in six studies on TPLO and one of the studies on TTA.…”

Adding Krill Oil and Low Molecular Weight Hyaluronic Acid to Movoflex® Soft Chews Helps Improve Dogs’ Mobility

“…Since OA is associated with HA degradation over time, the HA administered was, mainly, of high molecular weight (MW) and usually injected directly into the joint [33]. However, oral forms can also be used with good bioavailability and efficacy [34,35]. A study has shown that HA of high MW can be found in dogs' joints after oral administration [36].…”