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Abstract Background The changes in synovial fluid biomarkers after intra‐articular injection of hyarulonic acid (IA HA) remain controversial. We investigate the changes in the properties of synovial fluid (SF) and clinical symptoms before the first and fifth IA HA. Methods A total of 73 patients (73 knees) with symptomatic knee osteoarthritis were treated with five weekly intra‐articular injections of HA and 55 patients (55 knees) were analyzed. The SF total volume, viscosity, and levels of HA, chondroitin 4‐sulfate (C4S), chondroitin 6‐sulfate (C6S), keratin sulfate, and interleukin (IL)‐6 were measured before the first and fifth injections. Clinical evaluations were performed using the American Knee Society score for physician‐based outcome measurements and Knee injury and Osteoarthritis Outcome Score for patient‐based outcome measurements before the first and fifth injections. Results The SF viscosity and levels of HA were significantly increased, and the total SF volume and levels of chondroitin 4‐sulfate, chondroitin 6‐sulfate, and interleukin‐6 were significantly decreased. The physician‐based and patient‐based outcome scores were improved. Conclusions Our findings speculate that HA injections significantly modulate levels of intra articular biomarkers which may indicate beneficial effect for articular cartilage and synovium membrane.

We extend work by Pei-Ping and Gui-Xia, 2007, to a global optimization problem for more general functions. Pei-Ping and Gui-Xia treat the optimization problem for the linear sum of polynomial fractional functions, using a branch and bound approach. We prove that this extension makes possible to solve the following nonconvex optimization problems which Pei-Ping and Gui-Xia, 2007, cannot solve, that the sum of the positive (or negative) first and second derivatives function with the variable defined by sum of polynomial fractional function by using branch and bound algorithm.

Rapidly destructive coxarthrosis (RDC) is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA) development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.