Abstract: The effects of hyaluronic acid of different molecular weights on inflammatory pathways and the cellular activities of hyaluronic acid after specific binding to different receptors were systematically described. Mechanistic studies of hyaluronic acid of different molecular weights in the treatment of osteoarthritis and its clinical studies were also reviewed, mainly analyzing the role of hyaluronic acid in the treatment of osteoarthritis in maintaining intra-articular physicochemical properties, regulating inflammatory signaling pathways and protecting articular cartilage, and pointing out the shortcomings of intra-articular injection of hyaluronic acid in the treatment of osteoarthritis. This paper introduced the anti-inflammatory, pro-inflammatory and cartilage-protective effects of hyaluronic acid from the perspective of the treatment of osteoarthritis, with a view to providing a reference for the relevant research on hyaluronic acid treatment of osteoarthritis.

Key words: hyaluronic acid, osteoarthritis, anti-inflammatory, immunomodulation, cartilage protection