ArticlePloS one2019
Frictional characterization of injectable hyaluronic acids is more predictive of clinical outcomes than traditional rheological or viscoelastic characterization.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 46 citations in OpenAlex.
- Injection route affects intra-articular hyaluronic acid distribution and clinical outcome in viscosupplementation treatment for knee osteoarthritis: a combined cadaver study and randomized clinical trial.Drug delivery and translational research · 2021Trial
- Temporal Hierarchy of Hydrogels and Orthobiologic Therapies for Knee Osteoarthritis.Gels (Basel, Switzerland) · 2026Review
- Single-injection hyaluronic acid treatment demonstrates non-inferiority in the relief of symptomatic knee osteoarthritis: A randomized double-blind, multi-center controlled study.Osteoarthritis and cartilage open · 2026Article
- Rheological properties and clinical efficacy of a chemically modified hyaluronic acid for joint health enhancement.Drugs in context · 2026Review
- Development and tribological characterization of polyvinyl alcohol-based artificial cartilage forFrontiers in bioengineering and biotechnology · 2026Article
- Delayed Lubricin Injection Improves Cartilage Repair Tissue Quality in an In Vivo Rabbit Osteochondral Defect Model.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Viscosupplementation and Synovial Fluid Rheology: A Hidden Risk for Bacterial Biofilm Formation in Joint Infections?Microorganisms · 2025Review
- A self-healing radiopaque hyaluronic acid hydrogel as a new injectable biomaterial for precision medicine in osteoarthritis.Theranostics · 2025Article
- Crosslinking by Click Chemistry of Hyaluronan Graft Copolymers Involving Resorcinol-Based Cinnamate Derivatives Leading to Gel-like Materials.Gels (Basel, Switzerland) · 2024Article
- Loss of effective lubricating viscosity is the primary mechanical marker of joint inflammation in equine synovitis.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2024Article
- Advances in viscosupplementation and tribosupplementation for early-stage osteoarthritis therapy.Nature reviews. Rheumatology · 2024Review
- How Do Cartilage Lubrication Mechanisms Fail in Osteoarthritis? A Comprehensive Review.Bioengineering (Basel, Switzerland) · 2024Review
- Recombinant manufacturing of multispecies biolubricants.bioRxiv : the preprint server for biology · 2024Article
- Impact of hyaluronic acid injection on the knee joint friction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Ex Vivo Functional Benchmarking of Hyaluronan-Based Osteoarthritis Viscosupplement Products: Comprehensive Assessment of Rheological, Lubricative, Adhesive, and Stability Attributes.Gels (Basel, Switzerland) · 2023Article
- Comparison of Four Treatment Protocols with Intra-Articular Medium Molecular Weight Hyaluronic Acid in Induced Temporomandibular Osteoarthritis: An Experimental Study.International journal of molecular sciences · 2023Article
- Ultrasound-Guided Injections of HYADD4 for Knee Osteoarthritis Improves Pain and Functional Outcomes at 3, 6, and 12 Months without Changes in Measured Synovial Fluid, Serum Collagen Biomarkers, or Most Synovial Fluid Biomarker Proteins at 3 Months.Journal of clinical medicine · 2023Article
- Thermo-Responsive Hyaluronan-Based Hydrogels Combined with Allogeneic Cytotherapeutics for the Treatment of Osteoarthritis.Pharmaceutics · 2023Article
- A Hyaluronic Acid-Based Formulation with Simultaneous Local Drug Delivery and Antioxidant Ability for Active Viscosupplementation.ACS omega · 2022Article
- Hyaluronan and Derivatives: An In Vitro Multilevel Assessment of Their Potential in Viscosupplementation.Polymers · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hyaluronic acid injections have been a mainstay of arthritis treatment for decades. However, much controversy remains about their clinical efficacy and their potential mechanism of action. This approach to arthritis therapy is often called viscosupplementation, a term which is rooted in the elevated viscosity of the injected solutions. This terminology also suggests a mechanical pathway of action and further implies that their efficacy is dependent on viscosity. Notably, previous studies of the relationship between viscous properties of hyaluronic acid solutions and their clinical efficacy have not been definitive. Recently we developed an experimental and analytical framework for studying cartilage lubrication that captures the Stribeck-like behavior of cartilage in an elastoviscous transition curve. Here we apply this framework to study the lubricating behavior of six hyaluronan products currently used for injectable arthritis therapy in the US. Despite the fact that the source and chemical modifications endow these products with a range of lubricating properties, we show that the lubricating effect of all of these materials can be described by this Stribeck-like elastoviscous transition. Fitting this data to the elastoviscous transition model enables the calculation of effective lubricating viscosities for each material, which differ substantially from the viscosities measured using standard rheometry. Further we show that while data from standard rheometry are poor predictors of clinical performance of these materials, measurements of friction coefficient and effective lubricating viscosity correlate well (R2 = 0.77; p < 0.005) with assessments of improved clinical function reported previously. This approach offers both a novel method that can be used to evaluate potential clinical efficacy of hyaluronic acid formulations and provide new insight on their mode of action.
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Registered trials
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