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Journal of personalized medicine2023; 13(12); doi: 10.3390/jpm13121647

Clinical and Biochemical Implications of Hyaluronic Acid in Musculoskeletal Rehabilitation: A Comprehensive Review.

Abstract: Hyaluronic acid (HA) naturally occurs as a biopolymer in the human body, primarily in connective tissues like joints and skin. Functioning as a vital element of synovial fluid, it lubricates joints, facilitating fluid movement and diminishing bone friction to protect articular well-being. Its distinctive attributes encompass notable viscosity and water retention capacities, ensuring flexibility and absorbing shock during motion. Furthermore, HA has gained significant attention for its potential benefits in various medical applications, including rehabilitation. Ongoing research explores its properties and functions, especially its biomedical applications in several clinical trials, with a focus on its role in improving rehabilitation outcomes. But the clinical and biochemical implications of HA in musculoskeletal rehabilitation have yet to be fully explored. This review thoroughly investigates the properties and functions of HA while highlighting its biomedical applications in different clinical trials, with a special emphasis on its role in rehabilitation. The presented findings provide evidence that HA, as a natural substance, enhances the outcomes of musculoskeletal rehabilitation through its exceptional mechanical and biochemical effects.
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Publication Date: 2023-11-26 PubMed ID: 38138874PubMed Central: PMC10744407DOI: 10.3390/jpm13121647Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article explores the role of Hyaluronic acid (HA), a biopolymer naturally found in human body tissues, in musculoskeletal rehabilitation. The paper delves into its unique properties and functions within the body, how these are used in medical applications, especially in rehabilitation, and the need for further exploration of this substance’s clinical implications.

Role of Hyaluronic Acid (HA) in the Human Body

  • HA primarily exists in connective tissues such as joints and skin. It serves as a key component of synovial fluid, a substance that lubricates joints, ensuring smooth motion and reducing bone friction, thereby preserving joint health.
  • HA’s unique properties include high viscosity and water retention capacities which provide flexibility and absorb shocks during movement, further protecting joints from damage.

Applications of Hyaluronic Acid in Medical Science

  • Due to its advantageous properties, HA has gained substantial attention in the medical field. It has found potential uses in different areas, including the field of rehabilitation.
  • Research is ongoing to explore HA’s properties and functions, specifically its biomedical applications. Numerous clinical trials are focusing on the role of HA in improving rehabilitation outcomes.

Focus on Hyaluronic Acid in Musculoskeletal Rehabilitation

  • This research article takes a deep dive into how HA impacts musculoskeletal, or, movement related, rehab and recovery. While its implications have not yet been fully explored in this context, the review provides a comprehensive examination of HA’s properties and functions.
  • Some of the medical trials noted in the study specially emphasize the role of HA in the field of rehabilitation. These trials generally suggest that as a natural substance, HA can enhance musculoskeletal rehabilitation outcome by providing both mechanical and biochemical benefits.

Further Study of Hyaluronic Acid’s Role in Rehabilitation

  • The review stresses the need for more thorough investigation into the clinical and biochemical implications of HA in musculoskeletal rehabilitation.
  • As per the research conducted so far, promising evidence suggests that HA can positively impact the outcomes of musculoskeletal rehabilitation, which makes it worthy of further study.

Cite This Article

APA
Iaconisi GN, Gallo N, Caforio L, Ricci V, Fiermonte G, Della Tommasa S, Bernetti A, Dolce V, Farì G, Capobianco L. (2023). Clinical and Biochemical Implications of Hyaluronic Acid in Musculoskeletal Rehabilitation: A Comprehensive Review. J Pers Med, 13(12). https://doi.org/10.3390/jpm13121647

Publication

Journal of personalized medicine
ISSN: 2075-4426
NlmUniqueID: 101602269
Country: Switzerland
Language: English
Volume: 13
Issue: 12

Researcher Affiliations

Iaconisi, Giorgia Natalia
  • Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy.
Gallo, Nunzia
  • Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy.
Caforio, Laura
  • Department of Basic Medical Sciences, Neurosciences and Sense Organs, Aldo Moro University, 70121 Bari, Italy.
Ricci, Vincenzo
  • Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy.
Fiermonte, Giuseppe
  • Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, 70125 Bari, Italy.
Della Tommasa, Simone
  • Department for Horses, Faculty of Veterinary Medicine, Leipzig University, 04109 Leipzig, Germany.
Bernetti, Andrea
  • Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy.
Dolce, Vincenza
  • Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy.
Farì, Giacomo
  • Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy.
Capobianco, Loredana
  • Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy.

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 123 references
  1. Gallo N, Nasser H, Salvatore L, Natali M.L, Campa L, Mahmoud M, Capobianco L, Madaghiele M. Hyaluronic acid for advanced therapies: Promises and challenges.. Eur. Polym. J. 2019;117:134–147.
    doi: 10.1016/j.eurpolymj.2019.05.007google scholar: lookup
  2. Iaconisi G.N, Lunetti P, Gallo N, Cappello A.R, Fiermonte G, Dolce V, Capobianco L. Hyaluronic Acid: A Powerful Biomolecule with Wide-Ranging Applications—A Comprehensive Review.. Int. J. Mol. Sci. 2023;24:10296.
    doi: 10.3390/ijms241210296pmc: PMC10299688pubmed: 37373443google scholar: lookup
  3. Fallacara A, Baldini E, Manfredini S, Vertuani S. Hyaluronic Acid in the Third Millennium.. Polymers 2018;10:701.
    doi: 10.3390/polym10070701pmc: PMC6403654pubmed: 30960626google scholar: lookup
  4. Brandt K.D, Smith G.N.J, Simon L.S. Intraarticular injection of hyaluronan as treatment for knee osteoarthritis: What is the evidence?. Arthritis Rheum. 2000;43:192–203.
    doi: 10.1002/1529-0131(200006)43:6<1192::AID-ANR2>3.0.CO;2-Lpubmed: 10857778google scholar: lookup
  5. Kotla N.G, Mohd Isa I.L, Larrañaga A, Maddiboyina B, Swamy S.K, Sivaraman G, Vemula P.K. Hyaluronic Acid-Based Bioconjugate Systems, Scaffolds, and Their Therapeutic Potential.. Adv. Healthc. Mater. 2023;12:2203104.
    doi: 10.1002/adhm.202203104pubmed: 36972409google scholar: lookup
  6. Kotla N.G, Bonam S.R, Rasala S, Wankar J, Bohara R.A, Bayry J, Rochev Y, Pandit A. Recent advances and prospects of hyaluronan as a multifunctional therapeutic system.. J. Control Release. 2021;336:598–620.
    doi: 10.1016/j.jconrel.2021.07.002pubmed: 34237401google scholar: lookup
  7. Gupta R.C, Lall R, Srivastava A, Sinha A. Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory.. Front. Vet. Sci. 2019;6:192.
    doi: 10.3389/fvets.2019.00192pmc: PMC6603175pubmed: 31294035google scholar: lookup
  8. Grand View Research. [(accessed on 20 September 2023)]. Available online: https://www.grandviewresearch.com/press-release/global-hyaluronic-acid-market.
  9. Vasvani S, Kulkarni P, Rawtani D. Hyaluronic acid: A review on its biology, aspects of drug delivery, route of administrations and a special emphasis on its approved marketed products and recent clinical studies.. Int. J. Biol. Macromol. 2020;151:1012–1029.
    doi: 10.1016/j.ijbiomac.2019.11.066pubmed: 31715233google scholar: lookup
  10. Bravo B, Correia P, Gonçalves Junior J.E, Sant’Anna B, Kerob D. Benefits of topical hyaluronic acid for skin quality and signs of skin aging: From literature review to clinical evidence.. Dermatol. Ther. 2022;35:15903.
    doi: 10.1111/dth.15903pmc: PMC10078143pubmed: 36200921google scholar: lookup
  11. Oliva F, Marsilio E, Asparago G, Frizziero A, Berardi A.C, Maffulli N. The Impact of Hyaluronic Acid on Tendon Physiology and Its Clinical Application in Tendinopathies.. Cells 2021;10:3081.
    doi: 10.3390/cells10113081pmc: PMC8625461pubmed: 34831304google scholar: lookup
  12. Farì G, Santagati D, Pignatelli G, Scacco V, Renna D, Cascarano G, Vendola F, Bianchi F.P, Fiore P, Ranieri M. Collagen Peptides, in Association with Vitamin C, Sodium Hyaluronate, Manganese and Copper, as Part of the Rehabilitation Project in the Treatment of Chronic Low Back Pain.. Endocr. Metab. Immune Disord. Drug Targets. 2022;22:108–115.
    doi: 10.2174/1871530321666210210153619pubmed: 33568038google scholar: lookup
  13. Saccomanno M.F, Donati F, Careri S, Bartoli M, Severini G, Milano G. Efficacy of intra-articular hyaluronic acid injections and exercise-based rehabilitation programme, administered as isolated or integrated therapeutic regimens for the treatment of knee osteoarthritis.. Knee Surg. Sports Traumatol. Arthrosc. 2016;24:1686–1694.
    doi: 10.1007/s00167-015-3917-9pubmed: 26685691google scholar: lookup
  14. Onu I, Matei D, Galaction A. Efficacy of intra-articular hyaluronic acid injections in the rehabilitation programme of Knee Osteoarthritis.. BALNEO 2019:225–230.
    doi: 10.12680/balneo.2019.261google scholar: lookup
  15. Onu I, Matei D, Sardaru D.-P, Cascaval D, Onu A, Gherghel R, Serban I.L, Mocanu G.D, Iordan D.A, Murariu G. Rehabilitation of Patients with Moderate Knee Osteoarthritis Using Hyaluronic Acid Viscosupplementation and Physiotherapy.. Appl. Sci. 2022;12:3165.
    doi: 10.3390/app12063165google scholar: lookup
  16. Wilk K.E, Briem K, Reinold M.M, Devine K.M, Dugas J, Andrews J.R. Rehabilitation of articular lesions in the athlete’s knee.. J. Orthop. Sports Phys. Ther. 2006;36:815–827.
    doi: 10.2519/jospt.2006.2303pubmed: 17063841google scholar: lookup
  17. Başar B, Başar G, Büyükkuşçu M.Ö, Başar H. Comparison of physical therapy and arthroscopic partial meniscectomy treatments in degenerative meniscus tears and the effect of combined hyaluronic acid injection with these treatments: A randomized clinical trial.. J. Back. Musculoskelet. Rehabil. 2021;34:767–774.
    doi: 10.3233/BMR-200284pubmed: 33896812google scholar: lookup
  18. Monticone M, Frizziero A, Rovere G, Vittadini F, Uliano D, LA Bruna S, Gatto R, Nava C, Leggero V, Masiero S. Hyaluronic acid intra-articular injection and exercise therapy: Effects on pain and disability in subjects affected by lower limb joints osteoarthritis. A systematic review by the Italian Society of Physical and Rehabilitation Medicine (SIMFER). Eur. J. Phys. Rehabil. Med. 2016;52:389–399.
    pubmed: 26365146
  19. Desai A, Shendge P.N, Anand S.S. Evidence-based nutraceuticals for osteoarthritis: A review.. Int. J. Orthop. 2021;7:846–853.
    doi: 10.22271/ortho.2021.v7.i2k.2713google scholar: lookup
  20. Castrogiovanni P, Trovato F.M, Loreto C, Nsir H, Szychlinska M.A, Musumeci G. Nutraceutical Supplements in the Management and Prevention of Osteoarthritis.. Int. J. Mol. Sci. 2016;17:2042.
    doi: 10.3390/ijms17122042pmc: PMC5187842pubmed: 27929434google scholar: lookup
  21. Salwowska N.M, Bebenek K.A, Żądło D.A, Wcisło-Dziadecka D.L. Physiochemical properties and application of hyaluronic acid: A systematic review.. J. Cosmet. Dermatol. 2016;15:520–526.
    doi: 10.1111/jocd.12237pubmed: 27324942google scholar: lookup
  22. Dienes J, Browne S, Farjun B, Amaral Passipieri J, Mintz E.L, Killian G, Healy K.E, Christ G.J. Semisynthetic Hyaluronic Acid-Based Hydrogel Promotes Recovery of the Injured Tibialis Anterior Skeletal Muscle Form and Function.. ACS Biomater. Sci. Eng. 2021;7:1587–1599.
    doi: 10.1021/acsbiomaterials.0c01751pubmed: 33660968google scholar: lookup
  23. Maneiro E, de Andres M.C, Ferández-Sueiro J.L, Galdo F, Blanco F.J. The biological action of hyaluronan on human osteoarthritic articular chondrocytes: The importance of molecular weight.. Clin. Exp. Rheumatol. 2004;22:307–312.
    pubmed: 15144124
  24. Adams M.E, Lussier A.J, Peyron J.G. A risk-benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee.. Drug Saf. 2000;23:115–130.
    doi: 10.2165/00002018-200023020-00003pubmed: 10945374google scholar: lookup
  25. Guzińska K, Kaźmierczak D, Dymel M, Pabjańczyk-Wlazło E, Boguń M. Anti-bacterial materials based on hyaluronic acid: Selection of research methodology and analysis of their anti-bacterial properties.. Mater. Sci. Eng. C. Mater. Biol. Appl. 2018;93:800–808.
    doi: 10.1016/j.msec.2018.08.043pubmed: 30274115google scholar: lookup
  26. Gallo N, Iaconisi G.N, Pollini M, Paladini F, Pal S, Nobile C, Capobianco L, Licciulli A, Buonocore G.G, Mansi A. Efficacy Evaluation of Cu- and Ag-Based Antibacterial Treatments on Polypropylene Fabric and Comparison with Commercial Products.. Coatings 2023;13:919.
    doi: 10.3390/coatings13050919google scholar: lookup
  27. Huerta-Ángeles G, Nešporová K, Ambrožová G, Kubala L, Velebný V. An Effective Translation: The Development of Hyaluronan-Based Medical Products from the Physicochemical, and Preclinical Aspects.. Front. Bioeng. Biotechnol. 2018;6:62.
    doi: 10.3389/fbioe.2018.00062pmc: PMC5966713pubmed: 29868577google scholar: lookup
  28. Juhaščik M, Kováčik A, Huerta-Ángeles G. Recent Advances of Hyaluronan for Skin Delivery: From Structure to Fabrication Strategies and Applications.. Polymers 2022;14:4833.
    doi: 10.3390/polym14224833pmc: PMC9694326pubmed: 36432961google scholar: lookup
  29. Restaino O.F, Finamore R, Diana P, Marseglia M, Vitiello M, Casillo A, Bedini E, Parrilli M, Corsaro M.M, Trifuoggi M. A multi-analytical approach to better assess the keratan sulfate contamination in animal origin chondroitin sulfate.. Anal. Chim. Acta. 2017;958:59–70.
    doi: 10.1016/j.aca.2016.12.005pubmed: 28110685google scholar: lookup
  30. De Oliveira J.D, Carvalho L.S, Gomes A.M, Queiroz L.R, Magalhães B.S, Parachin N.S. Genetic basis for hyper production of hyaluronic acid in natural and engineered microorganisms.. Microb. Cell Fact. 2016;15:119.
    doi: 10.1186/s12934-016-0517-4pmc: PMC4930576pubmed: 27370777google scholar: lookup
  31. Abatangelo G, Vindigni V, Avruscio G, Pandis L, Brun P. Hyaluronic Acid: Redefining Its Role.. Cells 2020;9:1743.
    doi: 10.3390/cells9071743pmc: PMC7409253pubmed: 32708202google scholar: lookup
  32. Liang J, Jiang D, Noble P.W. Hyaluronan as a therapeutic target in human diseases.. Adv. Drug. Deliv. Rev. 2016;97:186–203.
    doi: 10.1016/j.addr.2015.10.017pmc: PMC4753080pubmed: 26541745google scholar: lookup
  33. Cowman M.K, Matsuoka S. Experimental approaches to hyaluronan structure.. Carbohydr. Res. 2005;340:791–809.
    doi: 10.1016/j.carres.2005.01.022pubmed: 15780246google scholar: lookup
  34. Monslow J, Govindaraju P, Puré E. Hyaluronan—A functional and structural sweet spot in the tissue microenvironment.. Front. Immunol. 2015;6:231.
    doi: 10.3389/fimmu.2015.00231pmc: PMC4432798pubmed: 26029216google scholar: lookup
  35. Roughley P.J, Mort J.S. The role of aggrecan in normal and osteoarthritic cartilage.. J. Exp. Orthop. 2014;1:8.
    doi: 10.1186/s40634-014-0008-7pmc: PMC4648834pubmed: 26914753google scholar: lookup
  36. Turley E.A, Noble P.W, Bourguignon L.Y. Signaling properties of hyaluronan receptors.. J. Biol. Chem. 2002;277:4589–4592.
    doi: 10.1074/jbc.R100038200pubmed: 11717317google scholar: lookup
  37. Cuff C.A, Kothapalli D, Azonobi I, Chun S, Zhang Y, Belkin R, Yeh C, Secreto A, Assoian R.K, Rader D.J. The adhesion receptor CD44 promotes atherosclerosis by mediating inflammatory cell recruitment and vascular cell activation.. J. Clin. Investig. 2001;108:1031–1040.
    doi: 10.1172/JCI200112455pmc: PMC200948pubmed: 11581304google scholar: lookup
  38. Nedvetzki S, Gonen E, Assayag N, Reich R, Williams R.O, Thurmond R.L, Huang J.F, Neudecker B.A, Wang F.S, Turley E.A. RHAMM, a receptor for hyaluronan-mediated motility, compensates for CD44 in inflamed CD44-knockout mice: A different interpretation of redundancy.. Proc. Natl. Acad. Sci. USA. 2005;101:18081–18086.
    doi: 10.1073/pnas.0407378102pmc: PMC539795pubmed: 15596723google scholar: lookup
  39. Viola M, Vigetti D, Genasetti A, Rizzi M, Karousou E, Moretto P, Clerici M, Bartolini B, Pallotti F, De Luca G. Molecular control of the hyaluronan biosynthesis.. Connect. Tissue Res. 2008;49:111–114.
    doi: 10.1080/03008200802148405pubmed: 18661323google scholar: lookup
  40. Huang M.H, Yang R.C, Chou P.H. Preliminary effects of hyaluronic acid on early rehabilitation of patients with isolated anterior cruciate ligament reconstruction.. Clin. J. Sport. Med. 2007;17:242–250.
    doi: 10.1097/JSM.0b013e31812570fapubmed: 17620776google scholar: lookup
  41. Lin W, Klein J. Recent Progress in Cartilage Lubrication.. Adv. Mater. 2021;33:2005513.
    doi: 10.1002/adma.202005513pubmed: 33759245google scholar: lookup
  42. Farì G, Pignatelli G, Macchiarola D, Bernetti A, Agostini F, Fornaro M, Mariconda C, Megna M, Ranieri M. Cartilage damage: Clinical approach.. Minerva Orthop. 2022;73:20–27.
    doi: 10.23736/S2784-8469.21.04174-2google scholar: lookup
  43. Neuman M.G, Nanau R.M, Oruña-Sanchez L, Coto G. Hyaluronic acid and wound healing.. J. Pharm. Sci. 2015;18:53–60.
    doi: 10.18433/J3K89Dpubmed: 25877441google scholar: lookup
  44. Farì G, de Sire A, Fallea C, Albano M, Grossi G, Bettoni E, Di Paolo S, Agostini F, Bernetti A, Puntillo F. Efficacy of Radiofrequency as Therapy and Diagnostic Support in the Management of Musculoskeletal Pain: A Systematic Review and Meta-Analysis.. Diagnostics 2022;12:600.
    doi: 10.3390/diagnostics12030600pmc: PMC8947614pubmed: 35328153google scholar: lookup
  45. Kosiński J, Jarecki J, Przepiorka-Kosińska J, Ratajczak M. Hyaluronic acid in orthopedics.. Wiad. Lek. 2020;73:1878–1881.
    doi: 10.36740/WLek202009114pubmed: 33099534google scholar: lookup
  46. Kobayashi T, Chanmee T, Itano N. Hyaluronan: Metabolism and Function.. Biomolecules 2020;10:1525.
    doi: 10.3390/biom10111525pmc: PMC7695009pubmed: 33171800google scholar: lookup
  47. Li C, Cao Z, Li W, Liu R, Chen Y, Song Y, Liu G, Song Z, Liu Z, Lu C. A review on the wide range applications of hyaluronic acid as a promising rejuvenating biomacromolecule in the treatments of bone related diseases.. Int. J. Biol. Macromol. 2020;165:1264–1275.
    doi: 10.1016/j.ijbiomac.2020.09.255pubmed: 33039536google scholar: lookup
  48. Gomis A, Pawlak M, Balazs E.A, Schmidt R.F, Belmonte C. Effects of different molecular weight elastoviscous hyaluronan solutions on articular nociceptive afferents.. Arthritis Rheum. 2004;50:314–326.
    doi: 10.1002/art.11421pubmed: 14730630google scholar: lookup
  49. Gomis A, Miralles A, Schmidt R.F, Belmonte C. Nociceptive nerve activity in an experimental model of knee joint osteoarthritis of the guinea pig: Effect of intra-articular hyaluronan application.. Pain 2007;130:126–136.
    doi: 10.1016/j.pain.2006.11.012pubmed: 17197090google scholar: lookup
  50. Yang X, Liang W, Li J, Liu P. A meta-analysis and systematic review of the therapeutic effects of arthroscopy combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis.. Ann. Palliat. Med. 2021;10:9859–9869.
    doi: 10.21037/apm-21-2145pubmed: 34628912google scholar: lookup
  51. Ingram K.R, Wann A.K, Angel C.K, Coleman P.J, Levick J.R. Cyclic movement stimulates hyaluronan secretion into the synovial cavity of rabbit joints.. J. Physiol. 2008;586:1715–1729.
    doi: 10.1113/jphysiol.2007.146753pmc: PMC2375686pubmed: 18202097google scholar: lookup
  52. Castrogiovanni P, Di Rosa M, Ravalli S, Castorina A, Guglielmino C, Imbesi R, Vecchio M, Drago F, Szychlinska M.A, Musumeci G. Moderate Physical Activity as a Prevention Method for Knee Osteoarthritis and the Role of Synoviocytes as Biological Key.. Int. J. Mol. Sci. 2019;20:511.
    doi: 10.3390/ijms20030511pmc: PMC6387266pubmed: 30691048google scholar: lookup
  53. Clark R.B, Schmidt T.A, Sachse F.B, Boyle D, Firestein G.S, Giles W.R. Cellular electrophysiological principles that modulate secretion from synovial fibroblasts.. J. Physiol. 2017;595:635–645.
    doi: 10.1113/JP270209pmc: PMC5285716pubmed: 27079855google scholar: lookup
  54. Arden N, Nevitt M.C. Osteoarthritis: Epidemiology.. Best. Pract. Res. Clin. Rheumatol. 2006;20:3–25.
    doi: 10.1016/j.berh.2005.09.007pubmed: 16483904google scholar: lookup
  55. Murphy L, Schwartz T.A, Helmick C.G, Renner J.B, Tudor G, Koch G, Dragomir A, Kalsbeek W.D, Luta G, Jordan J.M. Lifetime risk of symptomatic knee osteoarthritis.. Arthritis Rheum. 2008;59:1207–1213.
    doi: 10.1002/art.24021pmc: PMC4516049pubmed: 18759314google scholar: lookup
  56. Christensen R, Bartels E.M, Astrup A, Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: A systematic review and meta-analysis.. Ann. Rheum. Dis. 2007;66:433–439.
    doi: 10.1136/ard.2006.065904pmc: PMC1856062pubmed: 17204567google scholar: lookup
  57. Roos E.M, Arden N.K. Strategies for the prevention of knee osteoarthritis.. Nat. Rev. Rheumatol. 2016;12:92–101.
    doi: 10.1038/nrrheum.2015.135pubmed: 26439406google scholar: lookup
  58. Palazzo C, Nguyen C, Lefevre-Colau M.M, Rannou F, Poiraudeau S. Risk factors and burden of osteoarthritis.. Ann. Phys. Rehabil. Med. 2016;59:134–138.
    doi: 10.1016/j.rehab.2016.01.006pubmed: 26904959google scholar: lookup
  59. Jang S, Lee K, Ju J.H. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee.. Int. J. Mol. Sci. 2021;22:2619.
    doi: 10.3390/ijms22052619pmc: PMC7961389pubmed: 33807695google scholar: lookup
  60. Notarnicola A, Maccagnano G, Farì G, Bianchi F.P, Moretti L, Covelli I, Ribatti P, Mennuni C, Tafuri S, Pesce V. Extracorporeal shockwave therapy for plantar fasciitis and gastrocnemius muscle: Effectiveness of a combined treatment.. J. Biol. Regul. Homeost. Agents. 2020;34:285–290.
    doi: 10.23812/19-347-Lpubmed: 32191019google scholar: lookup
  61. Farì G, Megna M, Scacco S, Ranieri M, Raele M.V, Noya E.C, Macchiarola D, Bianchi F.P, Carati D, Gnoni A. Effects of Terpenes on the Osteoarthritis Cytokine Profile by Modulation of IL-6: Double Face versus Dark Knight?. Biology 2023;12:1061.
    doi: 10.3390/biology12081061pmc: PMC10452224pubmed: 37626947google scholar: lookup
  62. Farì G, Megna M, Scacco S, Ranieri M, Raele M.V, Chiaia Noya E, Macchiarola D, Bianchi F.P, Carati D, Panico S. Hemp Seed Oil in Association with β-Caryophyllene, Myrcene and Ginger Extract as a Nutraceutical Integration in Knee Osteoarthritis: A Double-Blind Prospective Case-Control Study.. Medicina 2023;59:191.
    doi: 10.3390/medicina59020191pmc: PMC9960141pubmed: 36837393google scholar: lookup
  63. Ayhan E, Kesmezacar H, Akgun I. Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis.. World J. Orthop. 2014;5:351–361.
    doi: 10.5312/wjo.v5.i3.351pmc: PMC4095029pubmed: 25035839google scholar: lookup
  64. Jones I.A, Togashi R, Wilson M.L, Heckmann N, Vangsness C.T. Jr. Intra-articular treatment options for knee osteoarthritis.. Nat. Rev. Rheumatol. 2019;15:77–90.
    doi: 10.1038/s41584-018-0123-4pmc: PMC6390843pubmed: 30498258google scholar: lookup
  65. Bruyère O, Honvo G, Veronese N, Arden N.K, Branco J, Curtis E.M, Al-Daghri N.M, Herrero-Beaumont G, Martel-Pelletier J, Pelletier J.P. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin. Arthritis. Rheum. 2019;49:337–350.
    doi: 10.1016/j.semarthrit.2019.04.008pubmed: 31126594google scholar: lookup
  66. Kon E, Di Matteo B, Delgado D, Cole B.J, Dorotei A, Dragoo J.L, Filardo G, Fortier L.A, Giuffrida A, Jo C.H. Platelet-rich plasma for the treatment of knee osteoarthritis: An expert opinion and proposal for a novel classification and coding system.. Expert. Opin. Biol. Ther. 2020;20:1447–1460.
    doi: 10.1080/14712598.2020.1798925pubmed: 32692595google scholar: lookup
  67. Fransen M, McConnell S, Harmer A.R, Van der Esch M, Simic M, Bennell K.L. Exercise for osteoarthritis of the knee: A Cochrane systematic review.. Br. J. Sports. Med. 2015;49:1554–1557.
    doi: 10.1136/bjsports-2015-095424pubmed: 26405113google scholar: lookup
  68. Abramoff B, Caldera F.E. Osteoarthritis: Pathology, Diagnosis, and Treatment Options.. Med. Clin. N. Am. 2020;104:293–311.
    doi: 10.1016/j.mcna.2019.10.007pubmed: 32035570google scholar: lookup
  69. Latourte A, Kloppenburg M, Richette P. Emerging pharmaceutical therapies for osteoarthritis.. Nat. Rev. Rheumatol. 2020;16:673–688.
    doi: 10.1038/s41584-020-00518-6pubmed: 33122845google scholar: lookup
  70. Laudy A.B, Bakker E.W, Rekers M, Moen M.H. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: A systematic review and meta-analysis.. Br. J. Sports. Med. 2015;49:657–672.
    doi: 10.1136/bjsports-2014-094036pubmed: 25416198google scholar: lookup
  71. Meheux C.J, McCulloch P.C, Lintner D.M, Varner K.E, Harris J.D. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review.. Arthroscopy. 2016;32:495–505.
    doi: 10.1016/j.arthro.2015.08.005pubmed: 26432430google scholar: lookup
  72. Hermann W, Lambova S, Muller-Ladner U. Current Treatment Options for Osteoarthritis.. Curr. Rheumatol. Rev. 2018;14:108–116.
    doi: 10.2174/1573397113666170829155149pubmed: 28875826google scholar: lookup
  73. Baselga García-Escudero J, Miguel Hernández Trillos P. Treatment of Osteoarthritis of the Knee with a Combination of Autologous Conditioned Serum and Physiotherapy: A Two-Year Observational Study.. PLoS ONE. 2015;10:0145551.
    doi: 10.1371/journal.pone.0145551pmc: PMC4692499pubmed: 26709697google scholar: lookup
  74. Bowman S, Awad M.E, Hamrick M.W, Hunter M, Fulzele S. Recent advances in hyaluronic acid based therapy for osteoarthritis.. Clin. Transl. Med. 2018;7:6.
    doi: 10.1186/s40169-017-0180-3pmc: PMC5814393pubmed: 29450666google scholar: lookup
  75. Ferreira R.M, Torres R.T, Duarte J.A, Gonçalves R.S. Non-Pharmacological and Non-Surgical Interventions for Knee Osteoarthritis: A Systematic Review and Meta-Analysis.. Acta Reumatol. Port. 2019;44:173–217.
    pubmed: 31356585
  76. Serban O, Porojan M, Deac M, Cozma F, Solomon C, Lenghel M, Micu M, Fodor D. Pain in bilateral knee osteoarthritis-correlations between clinical examination, radiological, and ultrasonographical findings.. Med. Ultrason. 2016;18:318–325.
    doi: 10.11152/mu.2013.2066.183.pinpubmed: 27622408google scholar: lookup
  77. Liao C.D, Chen H.C, Huang M.H, Liou T.H, Lin C.L, Huang S.W. Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials.. Int. J. Mol. Sci. 2023;24:6078.
    doi: 10.3390/ijms24076078pmc: PMC10094194pubmed: 37047058google scholar: lookup
  78. Miller L.E, Block J.E. An 8-Week Knee Osteoarthritis Treatment Program of Hyaluronic Acid Injection, Deliberate Physical Rehabilitation, and Patient Education is Cost Effective at 2 Years Follow-up: The OsteoArthritis Centers of America (SM) Experience.. Clin. Med. Insights Arthritis Musculoskelet. Disord. 2014;7:49–55.
    doi: 10.4137/CMAMD.S18356pmc: PMC4275112pubmed: 25574144google scholar: lookup
  79. Ma C, Li X, Pan Y, Tian H, Wang Z, Zhang X, Zheng X, Liu G, Duan K, Qie S. The efficacy of the leg swing and quadriceps strengthening exercises versus platelet-rich plasma and hyaluronic acid combination therapy for knee osteoarthritis: A retrospective comparative study.. Medicine. 2023;102:35238.
    doi: 10.1097/MD.0000000000035238pmc: PMC10508439pubmed: 37713885google scholar: lookup
  80. Nakagawa Y, Hyakuna K, Otani S, Hashitani M, Nakamura T. Epidemiologic study of glenohumeral osteoarthritis with plain radiography.. J. Shoulder Elbow. Surg. 1999;8:580–584.
    doi: 10.1016/S1058-2746(99)90093-9pubmed: 10633892google scholar: lookup
  81. Al-Mohrej O.A, Prada C, Leroux T, Shanthanna H, Khan M. Pharmacological Treatment in the Management of Glenohumeral Osteoarthritis.. Drugs Aging. 2022;39:119–128.
    doi: 10.1007/s40266-021-00916-9pubmed: 35044674google scholar: lookup
  82. Itoi E, Arce G, Bain G.I, Diercks R.L, Guttmann D, Imhoff A.B, Mazzocca A.D, Sugaya H, Yoo Y.S. Shoulder Stiffness: Current Concepts and Concerns.. Arthroscopy. 2016;32:1402–1414.
    doi: 10.1016/j.arthro.2016.03.024pubmed: 27180923google scholar: lookup
  83. Ibounig T, Simons T, Launonen A, Paavola M. Glenohumeral osteoarthritis: An overview of etiology and diagnostics.. Scand. J. Surg. 2021;110:441–451.
    doi: 10.1177/1457496920935018pubmed: 32662351google scholar: lookup
  84. Millar N.L, Meakins A, Struyf F, Willmore E, Campbell A.L, Kirwan P.D, Akbar M, Moore L, Ronquillo J.C, Murrell G.A.C. Frozen shoulder.. Nat. Rev. Dis. Primers. 2022;8:59.
    doi: 10.1038/s41572-022-00386-2pubmed: 36075904google scholar: lookup
  85. Brander V.A, Gomberawalla A, Chambers M, Bowen M, Nuber G. Efficacy and safety of hylan G-F 20 for symptomatic glenohumeral osteoarthritis: A prospective, pilot study.. PM R. 2010;2:259–267.
    doi: 10.1016/j.pmrj.2010.02.010pubmed: 20430327google scholar: lookup
  86. Mao B, Peng R, Zhang Z, Zhang K, Li J, Fu W. The Effect of Intra-articular Injection of Hyaluronic Acid in Frozen Shoulder: A Systematic Review and Meta-analysis of Randomized Controlled Trials.. J. Orthop. Surg. Res. 2022;17:128.
    doi: 10.1186/s13018-022-03017-4pmc: PMC8896272pubmed: 35241100google scholar: lookup
  87. Altmann R. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines.. Arthritis Rheum. 2000;43:1905–1915.
    doi: 10.1002/1529-0131(200009)43:9<1905::AID-ANR1>3.0.CO;2-Ppubmed: 11014340google scholar: lookup
  88. Zhao J, Huang H, Liang G, Zeng L.F, Yang W, Liu J. Effects and safety of the combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) in the treatment of knee osteoarthritis: A systematic review and meta-analysis.. BMC Musculoskelet. Disord. 2020;21:224.
    doi: 10.1186/s12891-020-03262-wpmc: PMC7149899pubmed: 32278352google scholar: lookup
  89. Di Giacomo G, de Gasperis N. Hyaluronic Acid Intra-Articular Injections in Patients Affected by Moderate to Severe Glenohumeral Osteoarthritis: A Prospective Randomized Study.. Joints. 2017;5:138–142.
    doi: 10.1055/s-0037-1605389pmc: PMC5738473pubmed: 29270542google scholar: lookup
  90. Di Giacomo G, De Gasperis N. The role of hyaluronic acid in patients affected by glenohumeral osteoarthritis.. J. Biol. Regul. Homeost. Agents. 2015;29:945–951.
    pubmed: 26753660
  91. Sinusas K. Osteoarthritis: Diagnosis and treatment.. Am. Fam. Physician. 2012;85:49–56.
    pubmed: 22230308
  92. Wang P.H, Wu C.H, Ma C.H, Chiu Y.C, Wu P.T, Jou I.M. Comparison of intra-articular injection of ArtiAid®-Mini with Ostenil®-Mini for trapeziometacarpal osteoarthritis: A double-blind, prospective, randomized, non-inferiority trial.. Jt. Dis. Relat. Surg. 2023;34:50–57.
    doi: 10.52312/jdrs.2023.876pmc: PMC9903103pubmed: 36700263google scholar: lookup
  93. Kwon Y.W, Eisenberg G, Zuckerman J.D. Sodium hyaluronate for the treatment of chronic shoulder pain associated with glenohumeral osteoarthritis: A multicenter, randomized, double-blind, placebo-controlled trial.. J. Shoulder Elbow Surg. 2013;22:584–594.
    doi: 10.1016/j.jse.2012.10.040pubmed: 23333168google scholar: lookup
  94. Tortato S, Pochini A.C, Andreoli C.V, Cohen C, Lara P.H.S, Belangero P.S, Ejnisman B. Hylan G-F 20 versus triamcinolone in the treatment of primary shoulder osteoarthritis. Randomized trial.. Acta Ortop. Bras. 2022;30:244410.
    doi: 10.1590/1413-785220223001e244410pmc: PMC8979357pubmed: 35431635google scholar: lookup
  95. Foster N.E, Anema J.R, Cherkin D, Chou R, Cohen S.P, Gross D.P, Ferreira P.H, Fritz J.M, Koes B.W, Peul W. Prevention and treatment of low back pain: Evidence, challenges, and promising directions.. Lancet. 2018;391:2368–2383.
    doi: 10.1016/S0140-6736(18)30489-6pubmed: 29573872google scholar: lookup
  96. Hartvigsen J, Hancock M.J, Kongsted A, Louw Q, Ferreira M.L, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J. What low back pain is and why we need to pay attention.. Lancet. 2018;391:2356–2367.
    doi: 10.1016/S0140-6736(18)30480-Xpubmed: 29573870google scholar: lookup
  97. Aicale R, Tarantino D, Maffulli N. Overuse injuries in sport: A comprehensive overview.. J. Orthop. Surg. Res. 2018;13:309.
    doi: 10.1186/s13018-018-1017-5pmc: PMC6282309pubmed: 30518382google scholar: lookup
  98. Minetto M.A, Giannini A, McConnell R, Busso C, Torre G, Massazza G. Common Musculoskeletal Disorders in the Elderly: The Star Triad.. J. Clin. Med. 2020;9:1216.
    doi: 10.3390/jcm9041216pmc: PMC7231138pubmed: 32340331google scholar: lookup
  99. Bisciotti G.N, Eirale C, Corsini A, Baudot C, Saillant G, Chalabi H. Return to football training and competition after lockdown caused by the COVID-19 pandemic: Medical recommendations.. Biol. Sport. 2020;37:313–319.
    doi: 10.5114/biolsport.2020.96652pmc: PMC7433324pubmed: 32879554google scholar: lookup
  100. Oliva F, Piccirilli E, Berardi A.C, Frizziero A, Tarantino U, Maffulli N. Hormones and tendinopathies: The current evidence.. Br. Med. Bull. 2016;117:39–58.
    doi: 10.1093/bmb/ldv054pubmed: 26790696google scholar: lookup
  101. Hollander K, Rahlf A.L, Wilke J, Edler C, Steib S, Junge A, Zech A. Sex-specific differences in running injuries: A systematic review with meta-analysis and meta-regression.. Sports Med. 2021;51:1011–1039.
    doi: 10.1007/s40279-020-01412-7pmc: PMC8053184pubmed: 33433864google scholar: lookup
  102. Del Buono A, Battery L, Denaro V, Maccauro G, Maffulli N. Tendinopathy and inflammation: Some truths.. Int. J. Immunopathol. Pharmacol. 2011;24:45–50.
    doi: 10.1177/03946320110241S209pubmed: 21669137google scholar: lookup
  103. Loiacono C, Palermi S, Massa B, Belviso I, Romano V, Di Gregorio A, Sirico F, Sacco A.M. Tendinopathy: Pathophysiology, Therapeutic Options, and Role of Nutraceutics. A Narrative Literature Review.. Medicina. 2019;55:447.
    doi: 10.3390/medicina55080447pmc: PMC6723894pubmed: 31394838google scholar: lookup
  104. Litwiniuk M, Krejner A, Speyrer M.S, Gauto A.R, Grzela T. Hyaluronic Acid in Inflammation and Tissue Regeneration.. Wounds. 2016;28:78–88.
    pubmed: 26978861
  105. Ciardulli M.C, Marino L, Lovecchio J, Giordano E, Forsyth N.R, Selleri C, Maffulli N, Porta G.D. Tendon and Cytokine Marker Expression by Human Bone Marrow Mesenchymal Stem Cells in a Hyaluronate/Poly-Lactic-Co-Glycolic Acid (PLGA)/Fibrin Three-Dimensional (3D) Scaffold.. Cells. 2020;9:1268.
    doi: 10.3390/cells9051268pmc: PMC7291129pubmed: 32443833google scholar: lookup
  106. Arshad Z, Lau E.J.S, Leow S.H, Bhatia M. Management of chronic Achilles ruptures: A scoping review.. Int. Orthop. 2021;45:2543–2559.
    doi: 10.1007/s00264-021-05102-5pmc: PMC8514369pubmed: 34089355google scholar: lookup
  107. Fitzpatrick J, Bulsara M, Zheng M.H. The Effectiveness of Platelet-Rich Plasma in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Clinical Trials.. Am. J. Sports Med. 2017;45:226–233.
    doi: 10.1177/0363546516643716pubmed: 27268111google scholar: lookup
  108. Frizziero A, Oliva F, Vittadini F, Vetrano M, Bernetti A, Giordan N, Vulpiani V, Santilli S, Masiero N, Maffulli N. Efficacy of ultrasound-guided hyaluronic acid injections in achilles and patellar tendinopathies: A prospective multicentric clinical trial.. Muscles Ligaments Tendons J. 2019;9:305–313.
    doi: 10.32098/mltj.03.2019.01google scholar: lookup
  109. Huang S.H, Hsu P.C, Wang K.A, Chou C.L, Wang J.C. Comparison of single platelet-rich plasma injection with hyaluronic acid injection for partial-thickness rotator cuff tears.. J. Chin. Med. Assoc. 2022;85:723–729.
    doi: 10.1097/JCMA.0000000000000736pubmed: 35507030google scholar: lookup
  110. Flores C, Balius R, Álvarez G, Buil M.A, Varela L, Cano C, Casariego J. Efficacy and tolerability of peritendinous hyaluronic acid in patients with supraspinatus tendinopathy: A multicenter, randomized, controlled trial.. Sports Med. Open. 2017;3:1–8.
    doi: 10.1186/s40798-017-0089-9pmc: PMC5459785pubmed: 28585109google scholar: lookup
  111. Kumai T, Muneta T, Tsuchiya A, Shiraishi M, Ishizaki Y, Sugimoto K, Samoto N, Isomoto S, Tanaka Y, Takakura Y. The short-term effect after a single injection of high-molecular-weight hyaluronic acid in patients with enthesopathies (lateral epicondylitis, patellar tendinopathy, insertional Achilles tendinopathy, and plantar fasciitis): A preliminary study.. J. Orthop. Sci. 2014;19:603–611.
    doi: 10.1007/s00776-014-0579-2pubmed: 24817495google scholar: lookup
  112. Markes A.R, Hodax J.D, Ma C.B. Meniscus Form and Function.. Clin. Sports Med. 2020;39:1–12.
    doi: 10.1016/j.csm.2019.08.007pubmed: 31767101google scholar: lookup
  113. Stocco E, Porzionato A, De Rose E, Barbon S, De Caro R, Macchi V. Meniscus regeneration by 3D printing technologies: Current advances and future perspectives.. J. Tissue Eng. 2022;13:20417314211065860.
    doi: 10.1177/20417314211065860pmc: PMC8793124pubmed: 35096363google scholar: lookup
  114. Logerstedt D.S, Ebert J.R, MacLeod T.D, Heiderscheit B.C, Gabbett T.J, Eckenrode B.J. Effects of and Response to Mechanical Loading on the Knee.. Sports Med. 2022;52:201–235.
    doi: 10.1007/s40279-021-01579-7pubmed: 34669175google scholar: lookup
  115. Kopf S, Beaufils P, Hirschmann M.T, Rotigliano N, Ollivier M, Pereira H, Verdonk R, Darabos N, Ntagiopoulos P, Dejour D. Management of traumatic meniscus tears: The 2019 ESSKA meniscus consensus.. Knee Surg. Sports Traumatol. Arthrosc. 2020;28:1177–1194.
    doi: 10.1007/s00167-020-05847-3pmc: PMC7148286pubmed: 32052121google scholar: lookup
  116. Machado G.C, Maher C.G, Ferreira P.H, Pinheiro M.B, Lin C.W, Day R.O, McLachlan A.J, Ferreira M.L. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: Systematic review and meta-analysis of randomised placebo controlled trials.. BMJ. 2015;350:1225.
    doi: 10.1136/bmj.h1225pmc: PMC4381278pubmed: 25828856google scholar: lookup
  117. Schaffer D, Florin T, Eagle C, Marschner I, Singh G, Grobler M, Fenn C, Schou M, Curnow K.M. Risk of serious NSAID-related gastrointestinal events during long-term exposure: A systematic review.. Med. J. Aust. 2006;185:501–506.
    doi: 10.5694/j.1326-5377.2006.tb00665.xpubmed: 17137455google scholar: lookup
  118. Arai T, Suzuki-Narita M, Takeuchi J, Tajiri I, Inage K, Kawarai Y, Eguchi Y, Shiga Y, Hozumi T, Kim G. Analgesic effects and arthritic changes following intra-articular injection of diclofenac etalhyaluronate in a rat knee osteoarthritis model.. BMC Musculoskelet. Disord. 2022;23:960.
    doi: 10.1186/s12891-022-05937-ypmc: PMC9641934pubmed: 36344944google scholar: lookup
  119. Zhang W, Nuki G, Moskowitz R.W, Abramson S, Altman R.D, Arden N.K, Bierma-Zeinstra S, Brandt K.D, Croft P, Doherty M. OARSI recommendations for the management of hip and knee osteoarthritis: Part III: Changes in evidence following systematic cumulative update of research published through January 2009.. Osteoarthr. Cartil. 2010;18:476–499.
    doi: 10.1016/j.joca.2010.01.013pubmed: 20170770google scholar: lookup
  120. Wang Z, Zhu P, Liao B, You H, Cai Y. Effects and action mechanisms of individual cytokines contained in PRP on osteoarthritis.. J. Orthop. Surg. Res. 2023;18:713.
    doi: 10.1186/s13018-023-04119-3pmc: PMC10515001pubmed: 37735688google scholar: lookup
  121. Balius R, Guillermo A.R, Fernando B.P, Domínguez M, Gastaldi E, Gómez A, Ibáñez L, Lara F, Leal A, León A. Evaluation of quality-of-life following treatment with Hymovis in patients with knee osteoarthritis and/or meniscal tear.. Clin. Exp. Rheumatol. 2023.
    doi: 10.21203/rs.3.rs-1368674/v3google scholar: lookup
  122. Berton A, Longo U.G, Candela V, Greco F, Martina F.M, Quattrocchi C.C, Denaro V. Quantitative Evaluation of Meniscal Healing Process of Degenerative Meniscus Lesions Treated with Hyaluronic Acid: A Clinical and MRI Study.. J. Clin. Med. 2020;9:2280.
    doi: 10.3390/jcm9072280pmc: PMC7408658pubmed: 32709084google scholar: lookup
  123. Bernetti A, Agostini F, Paoloni M, Raele M.V, Farì G, Megna M, Mangone M. Could Hyaluronic Acid Be Considered as a Senomorphic Agent in Knee Osteoarthritis? A Systematic Review.. Biomedicines. 2023;11:2858.
    doi: 10.3390/biomedicines11102858pmc: PMC10604344pubmed: 37893231google scholar: lookup
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