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Glycosaminoglycans

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Can Hyaluronic Acid Reduce Friction in the First Extensor Compartment? A Cadaveric Study.

Gilad Rotem^1,2,3, Emma Badowski^1,4, Matan J Cohen⁵

¹University of Western Ontario, Roth McFarlane Hand & Upper Limb Centre, St Joseph's Health Care, London, Ontario, Canada.

Journal of Wrist Surgery

|March 23, 2026

Summary

This summary is machine-generated.

Hyaluronic acid (HA) significantly reduced friction in De Quervain

Keywords:

De Quervain's tenosynovitis biomechanical corticosteroid extensor tendons friction testing gliding resistance hand surgery hyaluronic acid

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Published on: October 28, 2022

Area of Science:

Orthopedics
Biomedical Engineering
Musculoskeletal Research

Background:

De Quervain's tenosynovitis (DQT) involves first dorsal compartment thickening, causing pain and dysfunction.
Current treatments include injections, physiotherapy, braces, and surgery.
Hyaluronic acid (HA) possesses lubricating properties, suggesting potential for improving tendon gliding.

Purpose of the Study:

To investigate hyaluronic acid (HA) as a nonsurgical treatment for De Quervain's tenosynovitis (DQT).
To evaluate HA's effect on tendon gliding at the tendon-retinaculum interface.
To compare the friction-reducing effects of HA versus a corticosteroid.

Main Methods:

Biomechanical cadaveric study involving 18 first extensor tendon compartments.
Specimens were treated with either HA or celestone soluspan (corticosteroid).
Friction measurements were taken between abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons and the extensor retinaculum at specific wrist-thumb angles.

Main Results:

Hyaluronic acid (HA) significantly reduced friction by 18.7% compared to saline.
The greatest friction reduction with HA was observed in the extensor pollicis brevis (EPB) tendon at a 30 to 20-degree wrist-thumb angle.
Celestone soluspan was used as a comparator in the friction measurements.

Conclusions:

Hyaluronic acid (HA) demonstrates potential as an effective nonsurgical treatment for De Quervain's tenosynovitis (DQT).
HA may improve tendon gliding by reducing friction in the first dorsal compartment.
Further clinical trials are warranted to validate these findings.