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Hyaluronic acid + mannitol is a combination used primarily for viscosupplementation in osteoarthritis treatment. The addition of mannitol, a polyol with antioxidant properties, protects hyaluronic acid from reactive oxygen species (ROS)-mediated degradation, potentially extending its intra-articular residence time without substantially modifying its rheological behavior. This combination may provide enhanced therapeutic effects compared to hyaluronic acid alone, including better pain relief, improved joint function, and possible chondroprotective effects through inhibition of matrix metalloprotease expression.
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