A discovery by Cornell University bioengineers is shedding new light on the controversy surrounding the effectiveness of a common treatment for osteoarthritis pain in the knee. Injections of hyaluronic acid (HA), intended to replace natural HA and restore lubrication to the joint, is a frequently prescribed treatment for the condition that affects some 27 million Americans. But studies of the 8 different HA products currently approved by the FDA have yielded inconclusive results on their effectiveness. In their article “Elastoviscous Transitions of Articular Cartilage Reveal a Mechanism of Synergy between Lubricin and Hyaluronic Acid”, published November 24 in the journal PLOS ONE, the Cornell team believe they have uncovered the key as to how HA functions in the body.
The researchers discovered that another molecule, lubricin, helps to anchor HA to the tissue surface, resulting in a low-friction environment that promotes better joint movement. Thus, the efficacy of any particular HA treatment may depend on the amount of lubricin present in the joint at the time of injection. Lawrence Bonassar, PhD, professor of biomechanical engineering commented that the findings “…could explain why clinical trials of HA have such variable outcomes and may also suggest new formulations of HA that might be even more effective in the clinic.” Similar to a car hydroplaning on a wet road, a highly viscous HA solution forms a pressurized film that lowers the friction coefficient of the cartilage, he explained.
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Read more about the findings here.
The journal article may be read here.