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खुला एक्सेस

अमूर्त

Viscosupplementation with Hyaluronic Acid or Polynucleotides: Results and Hypothesis for Condro-synchronization

Saggini R, Di Stefano A, Capogrosso F, Carniel R, Haidar Hassan K and Bellomo RG

In literature the treatment of rotator cuff syndrome is basically conservative using NSAIDs, cortisone infiltrations and cryotherapy to relieve pain, electroanalgesia, kinesiotherapy to restore the impaired mobility of the joint and strengthen the muscles, physical therapies using energy such as ultrasound, laser, hyperthermia and shock waves. In the case of lack of response to conservative treatment, arthroscopic surgery can be proposed. International literature is unanimous in considering the viscosupplementation as an effective treatment for reducing pain associated with the rotator cuff syndrome and improve joint function. The intra-articular treatment should ideally not only ensure the
mechanical protection of the articular surface, but also rebalance homeostasis of chondrocytes through the restoration of the microenvironment and nutritional supplements of the joint. The aim of this study was to evaluate the efficacy of viscosupplementation with hyaluronic acid and polynucleotides in the treatment of patients with rotator cuff syndrome for incomplete lesion of the supraspinatus. 80 subjects (43 M - 37 F) aged between 40 and 65 years (average age 54) were evaluated and treated. All they suffered from rotator cuff syndrome with incomplete injury of the tendon of the supraspinatus ascertained clinically and by ultrasound examination and MRI. The subjects were randomly divided into 2
groups (A and B). Group A made 4 sessions of infiltrative treatment with hyaluronic acid, once per week. Group B made 4 sessions of infiltrative treatment with infiltrative polynucleotides, 1 time per week. All subjects performed, during the whole period of treatment, upper limb proprioception and joint ROM functional recovery with Multi Joint System (MJS) at a frequency of 3 weekly sessions each one of 45 minutes. The results are comparable in the two groups in terms of improvement in both short and medium term. In view of these evidences we could hypothesize that the association of supplementation of the 2 elements, given together or temporally delayed could be further significant for an additional
maintenance of results in the long term.