2020
DOI: 10.1186/s12891-020-03577-8
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Efficacy of single high-molecular-weight versus triple low-molecular-weight hyaluronic acid intra-articular injection among knee osteoarthritis patients

Abstract: Background: To compare intra-articular (IA) knee injections of a cross-linked high-molecular-weight hyaluronic acid (HMW-HA) with a linear low-molecular weight HA (LMW-HA) in terms of pain and functional improvement among knee osteoarthritis (OA) patients. Methods: In this single-blinded RCT, the patients were randomly divided into two groups for HA injections. The first group received an HMW-HA (Arthromac) injection, while the other received three weekly LMW-HA (Hyalgan) injections. Pain and function were ass… Show more

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Cited by 19 publications
(13 citation statements)
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“…It is well established that low molecular weight proteins have high expression and better folding compared to larger ones, so we aimed to remove PDZ domains from trypsin‐like domains using protein engineering. PDZ domains normally have a regulatory function in the complete enzyme construct 7,16 . For truncating these domains, a stop codon was introduced through site‐directed mutagenesis at 249 positions in the protein sequence (Figure 1) and further confirmed by the Sanger sequencing.…”
Section: Resultsmentioning
confidence: 99%
See 1 more Smart Citation
“…It is well established that low molecular weight proteins have high expression and better folding compared to larger ones, so we aimed to remove PDZ domains from trypsin‐like domains using protein engineering. PDZ domains normally have a regulatory function in the complete enzyme construct 7,16 . For truncating these domains, a stop codon was introduced through site‐directed mutagenesis at 249 positions in the protein sequence (Figure 1) and further confirmed by the Sanger sequencing.…”
Section: Resultsmentioning
confidence: 99%
“…PDZ domains normally have a regulatory function in the complete enzyme construct. 7,16 For truncating these domains, a stop codon was introduced through sitedirected mutagenesis at 249 positions in the protein sequence (Figure 1) and further confirmed by the Sanger sequencing. The mutated plasmid was transformed to BL21(DE3) for over-expression.…”
Section: Expression Purification and Characterization Of Trypsin-like...mentioning
confidence: 99%
“…209 High MW would provide longer lasting protective effects in OA-affected joints. 210 The capacity of HA to penetrate the cartilage ECM and directly modulate chondrocyte activity remains a matter of debate. A drawback of HA therapy is the preferred i.a.…”
Section: Restorage Of Joint Function By Viscosupplementation and Restmentioning
confidence: 99%
“…Many papers have reported that high MW CL HA is more effective than low MW HA. It has been reported that one administration of high MW HA has a similar effect to three administrations of low MW [85,86]. However, due to the specificity of crosslinking, pathological development of granulomatous inflammation, a pseudoseptic response, is also known [75].…”
Section: Cross-linked Hyaluronic Acidmentioning
confidence: 99%