The human joint is a dynamic organ in which continuous lubrication occurs over years.
The joint consists not only of the cartilaginous surfaces on both sides of the bone but also of the capsule which is the mantle surrounding the contact area of both sides of the joint. Looking at the joints over the years, you can see that over the years, the amount of matrix has depleted, which is actually the material that makes up the cartilage surface.
The treatment of an injured joint can be based on cartilage protective supplements, drug therapy, muscle strengthening around the joint in physiotherapy or instrumentation such as therapy reset as well as injections into the joint space.
The most commonly used injection is a cortisone-based cortisone injection that actually reduces the degree of inflammation in the joint by acting on the pathway that generates it.
The additional injection that is often used is a shot of hyaluronic acid, which actually constitutes a kind of lubricating fluid like oil for the human joint, which will separate it in terms of the rheological properties of the substance. In other words, the tendency of the material to behave like a gel results in a better smoothing of the joints, thus reducing pain and inflammation. There is another mechanism by which the acid also acts (in the past it was called a chicken COMB injection because in the past the injections were made from chicken combs and so there were many allergic reactions to hyaluronic acid). Today I use only bacteria-derived substances for the treatment of hyaluronic acid injections into joints
There is another theory as to the role of hyaluronic acid in injections into joints as a treatment for cartilage erosion and is related to the acid decomposition products. It is believed that the decomposition products result in an increased amount of acid in the synovium cells at the margins of the joint. I mean, the cartilage cells "sense" the acid's decomposition products and in fact treat it like a lot of hyaluronic acid has been destroyed and now there is room to replace and produce acid.
Another type of injection is biological injection into a joint, and it is generally accepted to include PRP injections that mean platelet rich plasma as well as injections that are defined as autologous conditioned serum such as orthokine or orthokine as often written and which represent the new generation of joint treatments.
Not every joint should be injected and I do my best to convey and clarify to the patient the chances of the joint being injected. Choosing the right treatment and especially the treatment scheduling are important.
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