Comparative Rheological Characterization of Hyaluronic Acid Viscosupplements for Synovial Fluid Restoration in Osteoarthritis and Knee Biomechanics.
- 1i+Med S. Coop., Alava Technology Park, C/Hermanos Elhuyar 6, 01510 Vitoria-Gasteiz, Spain.
Abstract
Synovial fluid (SF) rheological properties deteriorate progressively in knee osteoarthritis (OA) due to a reduction in hyaluronic acid (HA) concentration and molecular weight, compromising joint lubrication and load distribution. Restoring these properties through intra-articular viscosupplementation with HA is a widely used therapeutic strategy. However, commercially available linear HA formulations differ substantially in their mechanical behavior, and single-parameter assessments are insufficient for capturing their functional differences. In this study, eight commercially available intra-articular linear HA hydrogels-TrHLINE 1%®, TrHLINE 2%®, Hyalubrix®, Hyalgan Bio®, Pronolis® HD 2.5%, Biolevox™ HA ONE 2.5%, Suplasyn®, and Arthrum H 2%®-were evaluated under standardized conditions using steady-state viscosity, mechanical stress response, first normal stress difference (N1), storage and loss moduli (G', G″), loss factor (tan δ), and elasticity percentage. Results revealed three distinct functional profiles: lubricant-oriented with low to moderate structural organization (Hyalgan Bio®, Suplasyn®, TrHLINE 1%®); balanced viscoelastic with sustained structural persistence (TrHLINE 2%®, Hyalubrix®, Arthrum H 2%®); and high initial rigidity with reduced dynamic persistence (Biolevox™ HA ONE 2.5%, Pronolis® HD 2.5%). These findings demonstrate that multi-parametric rheological benchmarking effectively discriminates functional differences among HA viscosupplements and supports indication-oriented product selection based on OA severity and patient mechanical demand.
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BibTeX
@article{melero2026comparative,
title = {{Comparative Rheological Characterization of Hyaluronic Acid Viscosupplements for Synovial Fluid Restoration in Osteoarthritis and Knee Biomechanics.}},
author = {Alejandro Melero and Ander Pino and José María Alonso and Nagore Martínez de Cestafe and Claudia Goenaga Ibeas and Amaia Huguet-Casquero and Miguel Ucelay López de Heredia and Raúl Pérez González},
journal = {Gels (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/gels12100882},
url = {https://europepmc.org/article/MED/42929916},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Rheological Characterization of Hyaluronic Acid Viscosupplements for Synovial Fluid Restoration in Osteoarthritis and Knee Biomechanics.
AU - Alejandro Melero
AU - Ander Pino
AU - José María Alonso
AU - Nagore Martínez de Cestafe
AU - Claudia Goenaga Ibeas
AU - Amaia Huguet-Casquero
AU - Miguel Ucelay López de Heredia
AU - Raúl Pérez González
PY - 2026
DA - 2026/09/30
JO - Gels (Basel, Switzerland)
DO - 10.3390/gels12100882
UR - https://europepmc.org/article/MED/42929916
AB - Synovial fluid (SF) rheological properties deteriorate progressively in knee osteoarthritis (OA) due to a reduction in hyaluronic acid (HA) concentration and molecular weight, compromising joint lubrication and load distribution. Restoring these properties through intra-articular viscosupplementation with HA is a widely used therapeutic strategy. However, commercially available linear HA formulations differ substantially in their mechanical behavior, and single-parameter assessments are insufficient for capturing their functional differences. In this study, eight commercially available intra-articular linear HA hydrogels-TrHLINE 1%®, TrHLINE 2%®, Hyalubrix®, Hyalgan Bio®, Pronolis® HD 2.5%, Biolevox™ HA ONE 2.5%, Suplasyn®, and Arthrum H 2%®-were evaluated under standardized conditions using steady-state viscosity, mechanical stress response, first normal stress difference (N1), storage and loss moduli (G', G″), loss factor (tan δ), and elasticity percentage. Results revealed three distinct functional profiles: lubricant-oriented with low to moderate structural organization (Hyalgan Bio®, Suplasyn®, TrHLINE 1%®); balanced viscoelastic with sustained structural persistence (TrHLINE 2%®, Hyalubrix®, Arthrum H 2%®); and high initial rigidity with reduced dynamic persistence (Biolevox™ HA ONE 2.5%, Pronolis® HD 2.5%). These findings demonstrate that multi-parametric rheological benchmarking effectively discriminates functional differences among HA viscosupplements and supports indication-oriented product selection based on OA severity and patient mechanical demand.
SN - 2310-2861
ER -