Primjena viskosuplemenata kao oblik liječenja bolesnika s artrozom koljena

master's thesis

• Title (english): Viscosupplementation as a treatment for knee osteoarthritis
• Author: Ana Giljanović
• Mentor: Mislav Jelić (mentor)
• Committee member: Tomislav Smoljanović (predsjednik povjerenstva)
• Committee member: Tomislav Đapić (član povjerenstva)
• Committee member: Mislav Jelić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Osteoartritis nije samo najčešća bolest zglobova, koja zahvaća više od 500 milijuna ljudi diljem svijeta, nego je i glavni uzrok invalidnosti u starijih osoba, s prevalencijom u porastu. Utvrđeno je da 80% globalnog opterećenja društva osteoartritisom uzrokuje osteoartritis koljena. Do sada nije pronađen učinkovit lijek koji bi modificirao tijek osteoartritisa pa se trenutno liječenje osteoartritisa uglavnom odnosi na kontrolu simptoma, odnosno kontrolu boli, što se najčešće postiže sistemskim analgeticima ili intraartikularnom primjenom glukokortikoida. Intraartikularne injekcije hijaluronske kiseline, poznate i kao viskosuplementacija, relativno su novija metoda liječenja čiji mehanizam djelovanja i dalje nije u potpunosti razjašnjen. Iako je poznato da hijaluronska kiselina vjerojatno ne može smanjiti postojeće strukturno oštećenje zgloba uzrokovano osteoartritisom ili zaustaviti napredak osteoartritisa, u određenom broju ljudi ona smanjuje bol i poboljšava funkciju zgloba, čime uvelike utječe na kvalitetu života pojedinca. Viskosuplementacija je uvjetno preporučena u smjernicama za liječenje osteoartritisa, ali predloženi pozitivni učinci hijaluronske kiseline trebali bi se uzeti u obzir, pogotovo u situacijama kada osoba ima značajne komorbiditete i kada je prva linija terapije kontraindicirana. Viskosuplementacija je kroz brojna klinička istraživanja pokazala nedosljedne rezultate što ju čini predmetom brojnih rasprava u svijetu ortopedije. Zbog njezine široke uporabe ključno je razumjeti njezinu učinkovitost, stoga se novija istraživanja o primjeni hijaluronske kiseline bave utvrđivanjem prediktivnih faktora povezanih s uspješnosti njezine primjene, definiranjem optimalnih terapijskih protokola i ocjenjivanjem sigurnosnog profila i učinkovitosti različitih proizvoda hijaluronske kiseline.

Abstract (english)

Osteoarthritis is not only the most common joint disease, which affects more than 500 million people worldwide, but also the leading cause of disability in older adults, that has significantly increased in prevalence. Knee osteoarthritis accounts for more than 80% of the burden of osteoarthritis. Currently, there are no effective disease-modifying osteoarthritis drugs, so the therapeutic approach mostly puts focus on symptom modification, such as pain alleviation, which is mostly accomplished by systemic analgesics or intra-articular corticosteroid injections. Intra-articular hyaluronic acid injection, also known as viscosupplementation, is a relatively new treatment option whose exact mechanism of action remains unknown. Even though hyaluronic acid probably cannot significantly decrease the rate of deterioration of joint structure or stop the progression of knee osteoarthritis, in some patients it can reduce pain and improve joint function, which can significantly influence their quality of life. Although viscosupplementation is conditionally recommended in official guidelines for treatment of knee osteoarthritis, proposed benefits of hyaluronic acid should not be ignored, especially in patients with significant comorbidities and contraindications for main treatment options. Viscosupplementation has shown varied results through numerous clinical trials and it is still ambiguous and controversial topic in orthopedics world. Because it is widely used, it is important to understand its effectiveness, which is the reason why recent research about hyaluronic acid application puts focus on identifying predictors of successful treatment, optimal therapeutic protocols, as well as, evaluation of safety profile and efficacy of different products of hyaluronic acid.

• Keywords: hijaluronska kiselina; koljeno; osteoartritis; viskosuplementacija
• Keywords (english): hyaluronic acid; knee; osteoarthritis; viscosupplementation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:974428
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-03 11:02:31