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BACKGROUND: Clinical studies have shown that sodium hyaluronate at different molecular weights exhibits therapeutic effects on osteoarthritis. OBJECTIVE: To investigate the changes in interleukin-1 beta, tumor necrosis factor-alpha, and matrix metalloproteinase-3 in synovial fluid of osteoarthritis rabbits after treatment with different molecular weights of sodium hyaluronate injection. METHODS: Forty rabbits (purchased from Qinghai Experimental Animal Center, China) were randomly divided into normal, model, macromolecule, and small molecule groups, with 10 rabbits in each group. The control group did not undergo any treatment. Rabbits in the remaining three groups were injected with papain via the right knee joint cavity to establish rabbit models of osteoarthritis. At 7 days after successful modeling, the right knee joint cavity of rabbits in the macromolecule and small molecule groups were injected with 0.3 mL of (1.5-2.5)x106 Da and (0.8-1.5)x106 Da sodium hyaluronate injection. Rabbits in the model group were injected with equal amounts of physiological saline, once a week, for 5 successive weeks. At 7 days after the last injection, the right knee joint cavity was examined by MRI, cartilage tissue was stained with hematoxylin-eosin, the level of inflammatory factors in the washing fluid was determined, and proteoglycan and collagen gene expression was detected. This study was approved by the Medical Ethics Committee of Qinghai Red Cross Hospital, China (No. 201802065). RESULTS AND CONCLUSION: MR imaging: There were joint effusion and incomplete cartilage surface in the model group. In the macromolecule group, cartilage surface was rough and cartilage layer became thinner compared with the model group. Hematoxyin-eosin staining: Obvious cartilage injury was observed in the model, macromolecule, and small molecule groups, but the injury in the macromolecule, and small molecule groups was milder than that in the model group. The injury in the small molecular group was milder than that in the macromolecule group. Measurement of inflammatory factors: Compared with the control group, the levels of interleukin-1 beta, tumor necrosis factor-alpha and matrix metalloproteinase-3 increased in the model group (P < 0.05). Compared with the model group, the levels of interleukin-1 beta, tumor necrosis factor-alpha and matrix metalloproteinase-3 decreased in the macromolecule and small molecule groups (P < 0.05). The levels of interleukin-1 beta and matrix metalloproteinase-3 in the small molecule group were lower than those in the macromolecule group. There was no significant difference in the level of tumor necrosis factor-alpha between small molecule and macromolecule groups. Gene detection: Proteoglycan and collagen gene expression levels were significantly lower in the model group than in the control, macromolecule and small molecule groups (P < 0.05). Proteoglycan and collagen gene expression levels were significantly lower in the macromolecule group than in the small molecule group (P < 0.05). These results suggest that compared with large molecular weight of sodium hyaluronate, small molecular weight of sodium hyaluronate can promote the repair of cartilage tissue in osteoarthritis and alleviate synovitis inflammation.
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Objective To investigate the clinical effect of intra-articular injection of sodium hyaluronate combined with psychological intervention in the treatment of knee osteoarthritis.MethodsA total of 90 patients with knee osteoarthritis treated in our hospital from June 2015 to June 2016 were selected as the research object, according to the different treatment methods, the patients were divided into two groups,with 45 cases in each group.The patients in the control group were treated with conventional treatment, while the observation group was treated with conventional therapy and intra-articular injection of sodium hyaluronate.The experimental data of the two groups were compared.ResultsAfter treatment, the changes of knee joint pain score, joint effusion and joint mobility in the observation group is better than those in the control group.The change of knee function score in the observation group was better than that in the control group.The clinical therapeutic effect of the observation group (95.6%) is better than that of the control group (75.6%);There was significant difference between the two groups (P<0.05);There were no serious adverse reactions in the two groups of patients receiving treatment,and there was no significant difference between the two groups.ConclusionThe clinical effect of intra-articular injection of sodium hyaluronate combined with psychological intervention in the treatment of knee osteoarthritis is good, which is worthy of clinical application.