Cornell study could inform debate over arthritis treatment regulation

Research at Cornell University could provide a better understanding of the science behind hyaluronic acid (HA) injections used to treat osteoarthritis.
According to a Cornell article, the medical community has been divided over how HA injections provide pain relief to osteoarthritis patients. HA products, typically injected into the knee, replace naturally occurring HA that has been depleted, lubricating the joints and preventing bones from rubbing together, according to the article.

The products are currently classified by the U.S. Food and Drug Administration as class III medical devices, meaning pain relief is achieved through mechanical actions, as opposed to chemical actions.

But in 2018, the FDA declared its intention to consider reclassifying HA products as drugs, citing scientific evidence that suggests HA achieves pain relief through chemical actions within the body.

A study led by Lawrence Bonassar, the Daljit S. and Elaine Sarkaria Professor in Biomedical Engineering and in Mechanical and Aerospace Engineering, provides new insight on HA's mode of action. Bonassar The researchers found the mechanical properties provided by HA's viscosity, specifically its ability to effectively lubricate cartilage, correlate much more directly to clinical efficacy – i.e., pain relief – than previously thought, according to the article.

The research, “Frictional Characterization of Injectable Hyaluronic Acids Is More Predictive of Clinical Outcomes Than Traditional Rheological or Viscoelastic Characterization,” was published May 10 in the journal PLoS One.
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