Synovial fluid

The exudate produced by the cartilaginous membranes of the joints is called synovial or joint fluid. It performs many functions in the body, the main of which is the protection of bone structures of the joint from premature wear. But with the influence of negative factors on the body, a deficiency or excess of synovial fluid is observed, which leads to serious impairment of the functioning of the articular joints.

Characteristic and composition

Intra-articular fluid is an elastic, natural lubricant that promotes safe and silent joint movement. It is secreted by epithelial cells that strengthen the joint capsule. The exudate contains 2 components – liquid and protein-polysaccharide. The fluid is blood plasma. Viscosity and elasticity are provided by the hyaluronan element, which is a polysaccharide of the glycosaminoglycan group.

The main function

For full functioning of the joint, up to 3 ml of joint fluid is sufficient, which prevents friction and premature wear of the bone tissue of the joint. Also, the exudate provides nutrition to the cartilaginous structures, has amortization capabilities, due to which the load during impacts is distributed evenly. If, for some reason, the synthesis is impaired, and there is an accumulation or, conversely, insufficient excretion of fluid, a disease develops, the name of which is synovitis.

The reason for the imbalance

The root causes of increased production of synovial fluid can be very diverse. Degenerative-inflammatory process, injuries and infectious diseases adversely affect the joints. If the disease is not prevented in a timely manner, the synovial membrane becomes inflamed, becomes thickened and provokes excessive secretion and accumulation of fluid in the joints.

The composition of the synovial fluid is different:

The reasons why fluid accumulates in the knee joint may be:

  • severe joint injuries
  • allergic reaction,
  • infection,
  • non-infectious factors
  • osteoarthrosis,
  • arthritis and arthrosis,
  • gout,
  • blood clotting disorder
  • weakening of immunity.

The disappearance of exudate can trigger such factors:

  • lack of fluid in the body,
  • unbalanced diet with a predominance of fatty and carbohydrate foods,
  • helminthic infestations,
  • malignant tumors in the joint cavity,
  • excessive exercise
  • advanced age, when the synthesis of hyaluronic acid slows down.

If you diagnose the pathology in the initial stages and strictly follow the treatment regimen prescribed by the doctor, recovery will come quickly. Otherwise, due to the lack of exudate, the inter-articular surface will deform and collapse.

Symptoms

Often fluid accumulates in a single joint, for example, in a knee or hip joint. If chronic synovitis develops, symptoms are not expressed, periods of exacerbation are replaced by remission. In acute course, the following symptoms are observed:

  • severe pain that worries in a calm and mobile state,
  • the formation of edema and an increase in the joint in size,
  • redness at the site of inflammation and a local increase in temperature,
  • violation of the articulation function, in which a person is not able to move the limb normally due to pain and swelling,
  • muscle cramps.

If the lubrication in the joints is insufficient, the risk of developing degenerative-destructive pathologies with the gradual destruction of cartilage structures increases. It is important to start treatment of the problem in a timely manner, because in advanced cases, the affected joint will completely lose its functionality, and the person will always be disabled.

Diagnostics

In order for the treatment of the pathology to be effective, it is necessary to establish an accurate diagnosis. For this, a laboratory study is prescribed, during which synovial fluid is taken from the diseased joint and examined macroscopically. The laboratory assistant evaluates the following parameters:

  • degree of transparency
  • viscosity,
  • Colour,
  • the number of cells in the preparation: if there are more than 100 units / μl, cytosis is diagnosed,
  • mucin clot formation rate.

What treatment is prescribed?

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Preparations

To eliminate the root cause of the development of the disease and related symptoms, a conservative method of therapy is prescribed. To speed up recovery, it is worth immobilizing the joint. To do this, an elastic bandage is applied to the joint. At the time of exacerbation, physical activity is prohibited. To eliminate the pain symptom and reduce inflammation, drugs of the non-steroidal anti-inflammatory group are used. In a chronic course, it is necessary to inject directly into the diseased joint. Glucocorticosteroid injections are prescribed, the course of use of which is determined by the doctor.

The infectious nature of synovitis is treated with antibiotics. In case of an allergic manifestation, a course of antihistamines is necessarily prescribed. In autoimmune disorders, cytostatics, anti-inflammatory and corticosteroid drugs are prescribed. If hemarthrosis is observed, drugs that have a hemostatic property are necessarily prescribed.

What foods strengthen joints?

Proper and balanced nutrition will help to increase the production of articular exudate. It is recommended to enrich the menu with products rich in vitamins, micro and macro elements. These are vegetables, fruits, red meat and fish, nuts, seeds, grapes, seafood, milk and dairy products. To make joints strong and elastic can:

How to restore synovial flu >

To restore normal volume of joint fluid, it is recommended to inject chondrotin and glucosamine, this:

The exercises that the physiotherapist selects will help speed up recovery. Useful are rotational, flexion-extensor movements, swings of a straight and bent limb in a joint. When performing a set of trainings, it is important that pain and discomfort are not bothered. At first, the loads are moderate, as the joints recover, the intensity of the classes will increase. In addition to exercise therapy, it is recommended to sign up for a massage course and physiotherapy, which will accelerate recovery.

If conservative therapy does not bring the desired result, surgical treatment of synovitis is performed. For diagnostic purposes, arthroscopy is prescribed. During the procedure, the doctor uses endoscopic equipment. The operation allows you to remove excess fluid from the cavity and, if necessary, examine the structure of the joint for pathological disorders. For pumping fluid, an arthrocenesis can be prescribed, during which the exudate is removed from the inter-articular space using a puncture needle. After that, an antibiotic and anti-inflammatory agent are injected into the joint.

Synovial fluid prosthesis: drugs for joint mobility

Hyaluronic acid (HA) – an indispensable component that is part of the joint fluid, responsible for its nutritional value, viscosity and elasticity. Perhaps everyone knows what value synovial fluid is for joints. Of course, first of all, it is the main food for hyaline cartilage, which lines the surfaces of bones interacting with each other. At the same time, the synovia that fills the joint cavity acts as a lubricating and moisturizing material for working bone surfaces, preventing their excessive friction, contributing to smooth gliding and good cushioning.

With arthritis and coxarthrosis, an excessively low concentration and distorted structure of HA molecules in the liquid content of the problem joint are observed, due to which its visco-elastic properties suffer. It is easy to understand that pathological dysfunction of the joint against a degenerative-dystrophic disease, complicated in addition by an acute violation of the consistency of synovia (the viscosity level is reduced), is critically aggravated every day, which leads to accelerated destruction of the cartilage. To stop destructive pathogenesis, doctors often recommend a synovial fluid prosthesis to their patients.

General drug information

A prosthesis is understood to mean a liquid preparation, the biologically active substance of which is hyaluronic acid. It is widely used in various fields of medicine, including orthopedics. A sterile solution of the corresponding component is injected into the joint capsule (intraarticularly), due to which the rheological properties of the natural fluid are actively restored and the physiological criteria of the structural parts of the joint affected by arthrosis are improved. The therapeutic effect is achieved due to:

  • normalization of viscosity and elasticity of natural lubricant;
  • restoration of tissue metabolism and hydrodynamics in the joint;
  • improving the nutrition of tissues of bone-cartilaginous formations;
  • reduce mechanical stress on the joint;
  • maintenance and long-term cartilage protection.

As a rule, animals are the source for obtaining a unique substance: HA is synthesized from cocks, glassy substance of the eyes of cattle, umbilical cord, and trachea of ​​mammals. That is, the synovial fluid prosthesis is a drug of natural origin. The produced biocompounds have good indicators of compatibility with the human body, but sometimes they can cause allergic reactions and some other complications, which we will notify about a little later. The tool is available in disposable syringes for single use.

The effect of intra-articular injection of the synovial fluid prosthesis is temporary, but rather long. The duration of action after passing one course is on average from 6 to 12 months, after which it is necessary to re-implant. To fully pass 1 course, you will need to do 3-5 injections of sodium hyaluronate with a certain sequence. The duration of the therapeutic effect and the specifics of the course depend on the molecular weight indicators of the ingredient used.

Direct saturation of the articulation of HA helps significantly reduce pain and increase the amplitude of movements in the problem department. Such therapy is most useful for the initial signs of degenerative-dystrophic changes, since in the early stages it is possible to achieve almost complete restoration of the cartilage tissue. In pathologies of moderate and severe form, the prosthesis replenishes the volume and viscosity of the synovial fluid, thereby mitigating the symptoms and preventing the progression of damage. Therefore, sometimes its use is advisable, for example, if it is necessary to delay the operation for total joint replacement.

Attention! Synovial replacement fluid, preparations containing sodium hyaluronate, produce a positive symptomatic effect. It is proved that they reduce the aggression of symptoms, reducing pain and improving the functional abilities of the affected locomotor part, but do not restore damaged structures and deformities with advanced osteoarthritis and rheumatoid arthritis. Therefore, specialists do not consider the intra-articular introduction of synovial fluid prostheses as an alternative to endoprosthetics.

Indications and contraindications

Synovial fluid prostheses in injection preparations can be offered to patients who experience painful discomfort and stiffness amid degenerative and post-traumatic diseases. As a rule, a similar technique is used when traditional conservative methods do not bring relief in deforming arthrosis. It is also used as a preventive measure to inhibit the progression of destructive processes in the articular cartilage. Such injections will be useful to people who, due to the age factor, natural lubrication, or synovia, is produced in unacceptably low quantities.

According to observations, at present, prostheses of synovial fluid of the knee joint are more often in demand, and this is not at all surprising. Let’s explain why. In recent years, there has been a sharp increase in injuries and a jump in the incidence of knee gonarthrosis. If earlier the hip section of the musculoskeletal system occupied a dominant position in terms of the frequency of lesions, today everything has changed radically. Unfortunately, this is the statistics, and it clearly shows a stable increase in the percentage of patients with severe damage to the knee joint.

With regard to contraindications, we first note that it is useless to treat knee joints and other segments with synovial fluid prostheses in the presence of local inflammations. The thing is that the acid, which is part of the liquid implant, is destroyed by pronounced inflammatory foci at the site of the proposed implantation zone, and there will be no sense in it. Therefore, at first a joint ailment accompanied by inflammation is brought into a state of remission, and only then hyaluronotherapy is used. Pregnant women and women during lactation, this method is contraindicated. There is no official evidence that it is safe for the fetus and newborn baby.

Important! It is undesirable to inject hyaluronate for any autoimmune pathologies, since it is not known how the body will react with a compromised immunological system and what health consequences such treatment will result in. In case of intolerance to biosynthesized or animal origin of synovial fluid, it is strictly forbidden to contact drugs! Cases of anaphylactic shock have been reported. Before using intra-articular prostheses, everyone needs to take a tolerance test for the synovial fluid analog.

Possible side effects

This innovative invention, despite minimally invasiveness and a high degree of safety, is not without side effects. Negative reactions prostheses of the analog synovial fluid, often prescribed for arthrosis of the knee joint, are rare. But they cannot be called completely harmless, if only because the main category of products sold by pharmaceutical companies has not been subjected to clinical trials.

Based on the minimum experimental clinical database and personal experience of patients who encountered problems after intra-articular use of hyaluronic acid, conclusions were drawn about the possible likelihood of the following consequences:

  • sensation of heat, itching at the injection site;
  • burning and irritation of the skin;
  • nettle fever;
  • swelling and redness of the soft articular tissues;
  • painful symptoms in nearby muscles;
  • local infectious and inflammatory reaction;
  • numbness, tingling, a feeling of “crawling creeps” in the limb;
  • anaphylactic shock.

As you can see, with all its positive qualities, innovative drugs produced as “synovial fluid” can also harm health. Efficiency is also not 100% guaranteed. Do not forget that each organism has its own individual characteristics, so there is no absolute guarantee of a successful outcome. In addition, it is unlikely that such therapeutic measures will yield results with pathofunctional changes in the articular elements in the terminal stages. Hence the conclusion: far from expensive treatment may well be ineffective.

Liquid implants: price and country of production

Before we list the most commonly used HA products intended for intraarticular administration, let us pay attention to an important point: all therapeutic manipulations should be carried out by a highly competent doctor in the rheumatology department, in compliance with all aseptic norms. In addition, in technical terms, this procedure is completely different from intramuscular injections, so only a professional medical professional can ensure the correct, non-traumatic and safe entry of the needle into the joint bag. The session is carried out under the supervision of ultrasound.

Functions of synovial fluid in the body: composition, production, diseases

Synovial fluid is a gel-like substance that is produced by the walls of the synovial sac. This element is needed for joints as a lubricant.

With a deficiency or excess of matter in the affected area, the ongoing metabolic processes are disturbed.

Synovial flu >Synovia, also known as synovial fluid, resembles an elastic mass with increased density that fills the cavity in the joint.

In a physiologically correct state, that is, normally it has a yellowish color or a completely transparent structure. The main function of this substance is the prevention of friction of surfaces in the joints, protection from premature wear and injury.

It also helps to maintain the correct ratio of the planes of cartilage on the joints, enhancing their motor ability.

Among other things, synovial fluid also provides nutrition to cartilage tissues that do not have their own circulatory system. It creates additional conditions for depreciation. The substance is not only synthesized by the synovial membrane, but also replenishes the volume of the joint cavity.

Synovia is divided in composition into two types of substances – protein-polysaccharide and liquid. The latter in structure is blood plasma. But the protein-polysaccharide component consists of an element that provides the viscosity of the substance – hyaluronate (included in the group of glucosaminglycans). It penetrates the collagen structure in the cartilage, making it elastic.

How is produced by the body

The composition is produced by the synovial bag in a sufficient, but small volume. Upon loading, a specific region of the OA through the spaces and pores of the joint from the deep cartilage layers appears synovia.

When the degree of load decreases, the mass again goes inside the cartilage structure. Therefore, the friction of cartilaginous surfaces is carried out practically without friction, even with high-intensity physical exertion. This is called enhanced lubrication.

With a lack of synovial fluid in the knee, hip, or shoulder joint, the sliding process is more difficult. This causes a creaking sensation of the articular surfaces. There are also situations where the fluid is secreted in sufficient volume, but its composition suffers from a lack of a number of elements, including chondroitin and glucosamine.

Due to the disrupted process of synovia production, various articular pathologies develop, including osteochondrosis, arthrosis, and so on.

Reasons for the lack

The reasons that affect the production and quality of synovial fluid are many. Play a role:

  • Lifestyle – sedentary or overly active;
  • Nutrition – a violation of the diet, lack of nutrients;
  • Age-related changes;
  • Excess weight;
  • Parasitic diseases;
  • Decreased immunity;
  • Hormonal disorders.

All these factors affect the volume and quality of synovia, which in the future may become the cause of the development of degenerative-dystrophic diseases. Some simply give an excessive load on the joint, and therefore the fluid produced is simply consumed and quickly destroyed, not having time to recover in the required volume.

Other factors affect the production process itself, reducing it. Still others have an effect on composition.

Symptoms and signs of shortage

There are a lot of signs of synovial fluid deficiency, but many of them are ignored until more severe joint damage occurs. The most striking signs are:

  • Squeaking, crunching of joints during movement;
  • Decrease in volume of movement, difficulty in mobility;
  • The manifestation at the beginning of the course of the disease of uncomfortable, and later – pain;
  • The manifestation of edema, redness of the skin, a local increase in temperature due to developing inflammation.

It should be noted that as the condition progresses, the surfaces of the joints are significantly injured, which can lead to the formation of osteophytes and deformation of bone structures.

Is it possible to slow down the process or recover

There are conditions in which the process of reducing production is inevitable, for example, in people of age. In this case, you can only slow down the negative impact. But at a young age, in most cases, the production of synovial fluid can be restored if the process is approached correctly.

Features of nutrition and diet

First of all, pay attention to the diet. She is responsible for the composition of synovia, as well as for the process of its production by the synovial membrane. The most useful products in this context are:

  • Natural fatty acids that are present in salmon, linseed oil, mackerel and olive oil;
  • Selenium, which is found in octopuses, legumes, liver and eggs;
  • Proteins in cereals, dairy, meat products;
  • Sulfur present in turkey and saltwater fish.

These elements allow you to recreate the proper nutrition of the synovial membrane and make it produce the required amount of substance.

Important! Some doctors believe that dishes based on gelatin and cartilage, including aspic, jellies, fruit jellies, will also be useful.

Lifestyle and recommendations

If we talk about lifestyle, then here the process depends on the whole on human activity. Moreover, it is very important to adhere to the “golden mean”. That is, low activity prevents the release of synovial fluid, and too intense – makes it insufficient. Therefore, it is required:

  • The correct organization of activity;
  • Proper conduct of rest and recovery;
  • The use of orthopedic products during training;
  • Conducting quality training, designed not for endurance, but for the study of all the required departments.

Thus, it will be possible to force the body to produce fluid in the required volume, as well as actively nourish the cartilage tissue of the joints.

Denture preparations

To improve the quality of cartilage, as well as a replacement for synovial fluid, drugs can act. They are used already when it comes to the pathological course of the condition.

NameCompositionPrice, rubles
FermatronSodium hyaluronate4300
HyalurChondroitin sulfate, sodium hyaluronate and so on,8700
GirouanSodium hyaluronate6400
OstenilSodium hyaluronate3300
GialganSodium hyaluronate4700
SinocromSodium hyaluronate6400
Hyalubrix (3 syringes)Sodium hyaluronate19500

There are a lot of drugs of this type. All of them are distributed in the form of injections for intraarticular administration. The main active substance is sodium hyaluronate, but in some embodiments, additional ingredients that enhance the composition of the drug may be present.

In the photo, the synovial capsule of the joint

Pathologies that are associated with synovial fluid include:

  • Osteochondrosis;
  • Артроз;
  • Synovitis;
  • Bursitis;
  • Infectious arthritis;
  • Hemarthrosis;
  • Rheumatoid arthritis.

Also, fluid outflow into the joint cavity can be affected by injuries. They contribute to the violation of the integrity of tissues, which leads invariably to a number of negative processes, including inflammation and subsequent dystrophy.

Forecast

Synovial fluid, like any other substance, is secreted by our body initially in sufficient volume. As they age, these processes slow down, and therefore reinforcement of this synthesis is necessary from the outside. That is, the treatment and prevention of pathological conditions, as well as special measures to activate processes in the joints.

In some situations, it is impossible to restore or simply slow down the pathological effect. In this case, it is recommended to buy special preparations for injection from a number of chondroprotectors and synovial fluid substitutes.

What is synovitis and how to treat it, see in our video:

What is synovial fluid and how to restore it

Synovial fluid or articular exudate is produced by the own cartilage membrane of the joints themselves.

Synovia is an elastic natural lubricant, without which the bones in the joints cannot move safely and silently.

The fluid performs the following functions in the joints:

  1. Lubricates the joint cavity from the inside.
  2. Serves as a natural shock absorber.
  3. It feeds cartilage tissue.
  4. Provides mobility of bones within the joint.
  5. Protects end surfaces of bones from premature wear.

The production of synovial fluid in both an adult and a child comes from several components:

  • water that is in the blood;
  • proteins with elastic collagen characteristics;
  • Hyaluron polysacchar >In its composition, synovia resembles blood plasma. But in plasma, the protein content is much higher, and hyaluronic acid is completely absent.

In appearance, the liquid is transparent, slightly yellowish and rather thick. Inside the joint from cartilaginous tissue, it stands out exactly as much as is required to ensure the full functioning of the joint.

If the load on the musculoskeletal system weakens, the excess synovial fluid is absorbed by the lymphatic vessels of the cartilage. Thanks to this mechanism, there is practically no friction in the joint, even with significant loads.

Imbalance leads to the fact that synovial fluid is produced little or, conversely, too much. For the full function of the joint, both are harmful.

Why there is an imbalance of synovia in the joint capsule

If the joints are deficient in lubrication, the end surfaces of the bones begin to rub against each other. This phenomenon is fraught with premature wear or irreversible destruction of the articular surfaces.

These processes are accompanied by discomfort, crunching and pain, and can even lead to a partial or complete limitation of mobility in the affected joints.

Here are the main reasons for the reduction in synovial exudate:

  1. low immunity;
  2. infections that cause dehydration;
  3. insufficient water intake;
  4. improper nutrition, which does not prov >If the synovial fluid in the joints is not contained in sufficient volume, the deprived joints begin to crackle and creak, thereby signaling a deficiency of articular exudate. Most dangerous if this situation occurs in the hip, elbow or knee joint.

The restoration of articular lubrication requires a competent approach and mandatory medical supervision. In order to prescribe adequate treatment, the doctor must establish the cause of the lack of joint fluid. To do this, the doctor directs the patient for tests and additional examinations.

Often, for a complete restoration of articular exudate, limiting the loads, adjusting the nutrition, satisfying the body’s needs for calcium preparations and drinking water is enough.

Unfortunately, seeking medical help most often comes too late, when conservative methods of treatment are already ineffective and surgical intervention is required.

The danger of lack of joint fluid

Imbalance of the lubricant in the hip, elbow or knee joint is fraught with degenerative changes in the cartilage tissue and the occurrence of various types of arthrosis that destroy the joints. Most often, arthrosis affects the hip joints. The pathology is called coxarthrosis. Coxarthrosis is dangerous destruction of the cartilage surfaces that cover the end bones of the joint.

Dystrophic, degenerative changes in the cartilage affect the production and regulation of the amount of synovial lubricant inside the joint – there is a catastrophic deficit. Violations in the qualitative composition of the synovia do not allow it, as before, to fully lubricate the hyaline surface, as a result of which it begins to crack and crumble.

Necrotic cartilage particles penetrate the joint fluid and damage the bones. The patient experiences severe pain during movement. The irreversible effects of arthrosis can be avoided only with timely treatment.

Excess synovia is also harmful and threatens with an insidious disease called bursitis. Due to the large volume of fluid, the joint bag is stretched, pathological tension of the joint capsule and excessive pressure occur in the joint cavity. This can lead to the inability to carry out any movement.

The inflammatory process is accompanied by general weakness, a rise in body temperature, and a severe pain syndrome. In the area of ​​the affected joint, swelling and swelling are observed.

Bursitis, depending on the stage and form of the disease, requires conservative or surgical treatment. To maximize mobility in the affected joint, treatment of arthrosis should be started as early as possible.

Inflammation of the inner articular membrane (synovitis) also refers to frequent pathologies that are typical of the hip and knee joints. The inflammatory process is accompanied by the accumulation in the hip joint of excess synovial fluid with impurities of pus and blood.

Synovitis often develops in children and is transient in nature. The disease can be triggered by an injury suffered by a viral or infectious disease. Symptoms of pathology include:

  • swelling;
  • muscle spasm;
  • lameness;
  • restriction of movements.

Synovitis can also occur in the knee joint, but this happens much less frequently than in the hip joint. The most effective is the complex therapy of pathology in the early stages of development.

Synovial fluid: what is it and how to restore it

Synovial fluid is an elastic, transparent and yellowish substance that fills the joint cavity. This liquid began to be studied in animals in the 19th century, then its existence was confirmed in humans.

The main function of this substance is to act as a lubricant and prevent joint friction, it also nourishes articular cartilage and acts as a shock absorber, increasing joint mobility.

Features

This fluid is released during loading from the deep layers of cartilage through the pores between the fibers. With reduced loads, the synovial fluid goes back to the cartilage cavity. This mechanism of action helps prevent friction inside the joint, even under heavy loads. The more the joint is loaded, the more fluid is released. This is ideal.

However, there are cases when the synovial fluid ceases to be secreted in sufficient volume, or its quality suffers. Most often, the fault is just the poor composition, namely the lack of glucosamine and chondroitin. Friction inside the joint leads to its rapid wear and development of diseases such as osteoarthritis.

There are several ways to restore synovial fluid, it is necessary to do this as early as possible so that irreversible changes in the joints do not occur.

How to restore synovial fluid?

The restoration of joint functions is a rather complex and lengthy process, it is necessary to approach it comprehensively. The production of synovia is assigned to the cells of the articular cartilage – chondrocytes. However, there are not so many of these cells in the cartilage, so some people have little articular fluid. You can improve the condition of the joints by following a few tips:

  1. Appropriate nutrition. It is better to give preference to natural products, excluding fast food, fatty, fried. Also, do not use sparkling water. It is better to eat often and in small portions.
  2. Physical activity. Moderate regular exercise will help accelerate metabolic processes in the body, as well as increase the production of synovia by articular cartilage. It is best if the doctor selects physical activity.
  3. Drug treatment includes taking various drugs to help restore the production of joint flu >

What does synovial fluid look like

As you can see there are not so many tips, the main thing is to have self-discipline and regularly follow them. If the first two points are all more or less simple, then the last two should be considered in more detail.

Medications

The composition of the synovial fluid is greatly influenced by the products of cartilage degeneration. The substance in the joint becomes less viscous, this leads to friction and a decrease in depreciation. To stimulate the production of chondrocytes (cartilage cells), it is necessary to take special drugs – chondroprotectors:

  • Arthra. Reduces pain, restores cartilage and improves joint mobility. The drug is available in the form of capsules and is taken orally at 2 tablets per day (the exact dosage is selected by the doctor). You need to take the drug for several months in a row. It is indicated for many diseases of the musculoskeletal system.
  • Teraflex. It stimulates the restoration of cartilage, has an anti-inflammatory effect at the cellular level. It is used for fractures, osteoarthritis and osteochondrosis. Available in capsules.
  • Stopartrosis is a dietary supplement (BAA), available in powder form. Crumpled with food. Promotes the formation of interarticular flu >

These are the most famous and effective drugs that can have a beneficial effect on the joints. Their disadvantage is that the visible effect is achieved only after six months of regular use. For a faster result, injections to the joint are used.

An injection is a quick way to deliver the right substance to the joint. Various injections relieve inflammation and pain, restore cartilage, or even act as a “prosthesis” of synovial fluid.

Hyaluronic acid preparations include ostenil, synvisc, synocrome. They improve intraarticular glide, cushioning and joint mobility. They prevent friction of the joints, thereby relieving pain when walking.

Alflutop is another drug for intra-articular administration, based on a concentrate of several fish species. It stimulates the production of hyaluronic acid in the human body, and also helps relieve inflammation.

In addition to intraarticular injections, intramuscular injections are also used. They have similar functions and are aimed at restoring cartilage tissue. These drugs include chondrolone, noltrex, alflutop, adgelon.

Folk remedies

You can choose the right folk remedy only with a doctor. The independent use of traditional medicine can lead to even greater health problems.

There are several time-tested recipes for restoring synovia:

  1. Alcoholic tincture of comfrey (100 g of the root of the plant in half a liter of alcohol). Tincture must be kept in a dark place for two weeks. Take a tablespoon three times a day.
  2. Decoction of comfrey root. 20 grams of root is poured with boiling water (400 ml) and tightly closed with a l >Synovial flu />

Normal and abnormal synovial fluid

Hyaluronic acid is the main component of synovial fluid. This fluid is synthesized by the synovial membrane of the joints. In appearance it is a viscous thick gel, transparent and colorless. The substance is retained within the joint due to intra-articular negative pressure.

Universal Hyaluronic Acid

It is present everywhere in the body – in the nervous, connective and epithelial tissue. If you examine the mucous membrane of any organ, then its presence will be revealed there. It is in the cornea of ​​the eye, the vitreous body, in all tendons and joints. The firmness and youth of the skin is also its merit. One molecule of acid can bind and hold an amount of water that exceeds its own weight by 10 times.

The adult body contains about 15 g of hyaluronic acid.

Hyaluronic acid is so needed by all organs because it is able to form a gel. The acid consists of long disaccharide chains connected to each other by glucuronic acid and acetylglucosamine molecules. Under an electron microscope, it looks like a volumetric grid. The biological properties of hyaluronic acid provide the cartilage with smooth gliding during movement.

Synovial fluid functions

Normally, large joints contain up to 4 ml of fluid, small joints – less. The functions of synovial fluid are to provide cushioning and nutrition for the joint. Cartilage has no blood supply, so everything you need is dissolved in the synovial fluid.

The constant movement of fluid, its movement and mixing ensure the entry of all nutrients into the cartilage.

Joint fluid function

Degenerative-dystrophic changes in the joint begin with a decrease in molecular weight and concentration of hyaluronic acid. When these two indicators reach a critically low value, slipping conditions worsen and cartilage destruction begins.

Clearance of the joint space decreases. Epiphyses of bones form bone outgrowths, or osteophytes. This leads to an even greater reduction in driving capabilities. The less movement, the worse the synovial fluid circulation. The resulting vicious circle cannot stop on its own.

The way out of the pathological situation is obvious: you need to return hyaluronic acid to the joint.

This is done using drugs of natural or synthetic origin.

Artificial synovial fluid is available in sterile syringes with a thin needle. The introduction of exogenous hyaluronic acid stimulates the start of its own synthesis. Cartilage that is fed has favorable conditions for recovery.

An artificial synovial fluid is produced either from natural raw materials or through the use of biotechnology. Chicken combs or vitreous eyes of cattle serve as natural raw materials.

Artificial synovial flu >They are divided by the molecular weight of hyaluronic acid, which is measured in daltons.

There are drugs of low and high molecular weight. A mass of 500-000 daltons is considered low, above 730 – high.

Low molecular weight preparations:

  • Gialgan Phidia, Italy, 4630 rubles;
  • Suplazin, Bioniche Pharma, 3015 rub .;
  • Intragel, Italy, 4500 rub.

Preparations with a mass of 1 daltons:

  • Dyuralan, solution for small joints, Bioventus, 15 400 rubles;
  • Dyuralan, Implant 3 ml, 21 470 rubles;
  • I lent 10 ml, Chemedika, 5 rubles;
  • Ostenil mini 1 ml, Chemedika, 2 160 rubles .;
  • Fermatron plus, Russia, 5000 rubles.

Preparations with a molecular weight of 2 to 3 million daltons:

  • Hyastat 2 ml, Russia, 2 rubles;
  • Hyalux 2 ml, South Korea, 4 rubles;
  • Sinokrom forte 2 ml, Kroma Pharma GMbH, 14 050 rubles;
  • Sinvisk 6 ml, USA, 19 500 rubles;
  • Visco plus 2 ml, Biomedical, Germany, 6 rubles.

Medicines with a maximum molecular weight of 6-7 daltons:

  • Synvisc one 6 ml, USA, 23 rubles;
  • Sinvisk Gilan GF 20, 23 600 rubles.

The choice of the drug is determined by the attending physician depending on the specific clinical picture, length of illness, degree of wear of the joint, age and occupation of the patient. The timing and frequency of administration of the drug into the joint is determined individually. Some drugs need to be administered 3-5 times a month, others – 1 time per year.

High-mass preparations have multiple intermolecular cross-links. This allows you to enter them once a year. They dissolve for a long time, providing anesthetic, wound healing, anti-inflammatory effect.

Introduction rules

You can enter only into the joint cavity. The introduction is preceded by a thorough examination using instrumental diagnostic methods. The presence of effusion is not a contraindication, it is first removed.

Before administration, the drug is heated to room temperature in a syringe. There may be slight pain and swelling at the injection site. It is necessary to preserve the joint for a week, you can apply ice, sometimes, as prescribed by a doctor, a light plaster cast is applied or an orthosis is put on for several days.

If the temperature rises in the first day after administration and the pain is disturbing, you should immediately consult a doctor.

In a week, relief should come. Sometimes it comes earlier, but a week is considered a target date. There are no rejection reactions. Sometimes there may be an allergic reaction to the drug from the crests of chickens.

What joints are the preparations intended for?

To say that this or that drug is “better” is impossible, each has its own purpose.

Hyalgan Phidia – an aqueous solution of hyaluronic acid, 5 injections are required per course, the advantage is a quick distribution in the capsule, some of the drug is absorbed into the adjacent muscles and ligaments. Sometimes it gives a local reaction in the form of edema and redness, it disappears within a day. Designed for large joints.

Ostenil Mini contains native hyaluronate and mannitol, which protects against free radicals. Thanks to this, the action is extended. The course requires 3-5 introductions. Immediately after the injection there is a feeling of heat, it is advisable to use ice. Suitable for large joints.

Dyuralan is introduced once a year, used for all joints. In large joints, 1 ml is injected, in small 3 ml with an interval of 1 months. Optionally administered during remission.

Synvisc is a hydrated gel. Do not inject with effusions.

Fermatron prevents the destruction of the joint, the action lasts up to 6 months. It is introduced with moderate osteoarthritis. Do not administer to pregnant women and children under 18 years of age.

Artificial synovial fluid removes the need for surgical treatment or endoprosthetics.

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

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