
Osteoarthritis (OA) is a degenerative joint disease that has grown significantly in prevalence. In 2019, approximately 528 million people were affected worldwide, with the knee being the most commonly afflicted joint. This condition impacts mobility and quality of life, particularly those over 55.
Hyaluronic acid injections such as Monovisc and Euflexxa have become prominent in treating knee OA. Monovisc offers a single-injection regimen, whereas Euflexxa is administered through three injections. Both treatments aim to improve joint function and reduce pain, but their approaches and outcomes may differ.
In this article, we examine these two treatments. We’ll discuss their effectiveness, patient satisfaction, and overall impact on knee OA management.
Key Takeaways
- Monovisc offers a single-injection treatment that uses cross-linked hyaluronic acid to mimic the natural fluid in knee joints. This process provides pain relief and improved mobility for people with knee osteoarthritis.
- Euflexxa requires a three-injection regimen made from highly purified linear chain hyaluronic acid. It effectively lubricates arthritic knees, reduces pain, and enhances joint function.
- Clinical trials show that both treatments significantly improve symptoms of knee osteoarthritis. Monovisc impresses with its convenience and potentially quicker relief due to fewer injections. At the same time, Euflexxa stands out for its consistent patient satisfaction ratings on effectiveness in managing pain and improving mobility.
- Both treatments have safety profiles with minimal side effects or mild adverse reactions mainly localized around the injection site, including pain, swelling, stiffness, or rash; other reported side effects include headaches and dizziness, but they are generally temporary.
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Introduction to Monovisc and Euflexxa
Knee osteoarthritis involves the wearing down of cartilage in the knee joint, leading to pain, stiffness, and reduced mobility. This condition affects millions worldwide, making it a significant cause of disability among adults.
Viscosupplementation treatments offer a breakthrough for patients suffering from knee osteoarthritis. By injecting hyaluronic acid directly into the knee joint, these therapies aim to improve the rheological properties of synovial fluid, reducing pain and enhancing mobility.
Composition and Mechanism of Action

Monovisc stands out because of its unique single-injection treatment designed to alleviate knee osteoarthritis pain. This viscosupplementation option utilizes a high-molecular-weight hyaluronic acid that is notably cross-linked to enhance the durability and effectiveness of the injection within the joint space.
The product also mimics the natural hyaluronic acid in the knee joint’s synovial fluid. This addition of hyaluronic acid improves the synovial fluid’s lubricating properties, reducing friction and wear in arthritic knees.
Euflexxa, another viscosupplementation treatment for knee osteoarthritis, uses a highly purified form of hyaluronic acid in its injections. This substance mimics the naturally occurring synovial fluid in the joints, lubricating and cushioning the knee to reduce pain during movement.
Moreover, Euflexxa mimics the natural hyaluronic acid in the body, a crucial component of the synovial fluid that lubricates joints. This treatment improves knee function and reduces pain by restoring the viscous properties of synovial fluid in arthritic knees.
Clinical Efficacy
Numerous clinical trials and studies have evaluated the efficacy of Monovisc in treating knee osteoarthritis. These research efforts reveal significant insights into its effectiveness and application as a viscosupplementation therapy. They can also serve as a basis for patients who want to discuss viscosupplementation by asking their doctor to compare Monovisc vs Orthovisc or Euflexxa.
- Monovisc, as a single-injection treatment, offers convenience compared to multi-injection regimens, aligning with findings that hypothesize similar efficacy between single and multiple dosages.
- Studies highlight Monovisc’s cross-linked structure of hyaluronic acid, which contributes to its durability and sustained improvement in knee joint function.
- Research into viscosupplementation treatments like Monovisc demonstrates their role in enhancing synovial fluid quality, thus easing joint movements and reducing osteoarthritic pain.
- One pivotal study confirmed that patients receiving Monovisc injections reported marked improvements in knee pain relief and joint mobility over the follow-up period.
Similar to Monovisc, clinical trials and studies also play a crucial role in evaluating the efficacy and safety of Euflexxa for treating knee osteoarthritis. Researchers have conducted extensive research to assess how well Euflexxa relieves pain and improves joint function in patients with osteoarthritis.
- A study found that Euflexxa has an average rating of 6.1 out of 10 from 258 ratings on Drugs.com, indicating significant patient-reported relief from knee osteoarthritis symptoms.
- Clinical evidence supports that Euflexxa and Monovisc provide effective pain management in knee osteoarthritis, improving patients’ quality of life.
- Compared to other non-surgical treatments, Euflexxa demonstrated more significant benefits for pain relief and enhanced joint function, showcasing its strong position among viscosupplementation options.
- Patient reviews on Drugs.com show that satisfaction with Euflexxa is slightly lower than that of Orthovisc by approximately 3%, guiding physicians to consider patient preferences and experiences during treatment recommendations.
- Clinical comparisons between hyaluronic acid injections like Euflexxa and alternative treatment regimens highlight the importance of selecting the appropriate dosing schedule for optimal outcomes. Euflexxa typically requires a three-injection course for full efficacy.
With an average rating of 6.1 out of 10 from 258 ratings on Drugs.com, Euflexxa’s impact is notable. According to Drugs.com’s indicators, its patient reviews are only 3% lower than those of Orthovisc, another viscosupplementation.
Safety Profiles

When considering treatment options for knee osteoarthritis, understanding the safety profiles of Monovisc and Euflexxa is essential. Both treatments are hyaluronic acid injections designed to relieve pain by lubricating the knee joint. However, each has specific safety considerations, adverse reactions, and side effects.
Adverse Reactions and Side Effects
- Injection Site Reactions: The most common side effects of Monovisc and Euflexxa include pain, swelling, redness, and warmth at the injection site. These reactions are typically mild and resolve within a few days.
- Joint Pain and Swelling: Some patients may experience increased joint pain or swelling shortly after the injection, which usually subsides with rest and ice.
- Local Inflammation: In rare cases, patients might develop local inflammatory reactions, including synovitis (joint lining inflammation).
- Infection: Though rare, there is a risk of infection at the injection site. Proper aseptic technique during administration minimizes this risk.
- Allergic Reactions: Hypersensitivity reactions are uncommon but can occur. Symptoms may include rash, itching, and difficulty breathing.
Both treatments have a low risk of severe complications, such as infection and allergic reactions. Proper administration and adherence to aseptic techniques are crucial in minimizing these risks.
Patients considering Monovisc or Euflexxa for knee osteoarthritis should discuss the potential side effects and adverse reactions with their healthcare provider to make an informed decision based on their health profile and treatment goals.
Practical Considerations

Administering injections requires a detailed understanding of injection protocols to ensure optimal patient outcomes. Monovisc is typically administered as a single 4 mL injection directly into the knee joint. This single-dose regimen is designed for simplicity and convenience, reducing the need for multiple office visits.
Meanwhile, Euflexxa is administered as a series of three 2 mL injections one week apart. This multi-dose regimen requires three separate office visits over three weeks.
Cost Comparison Between Monovisc and Euflexxa
The cost of Monovisc can range from $1,000 to $1,200 per injection. The single-dose nature of Monovisc may result in lower overall treatment costs when considering fewer office visits and injections.
On the other hand, the cost of Euflexxa is generally around $300 to $500 per injection, totaling approximately $900 to $1,500 for the complete three-injection series. While the per-injection cost is lower than Monovisc, the total cost may be comparable due to the need for multiple doses.
Insurance coverage for both Monovisc and Euflexxa varies. Patients should check with their insurance provider to determine the extent of coverage and potential out-of-pocket costs for each treatment option.
Patient Satisfaction and Outcomes
Patients who have received Monovisc appreciate the convenience of a single injection, which reduces the frequency of office visits and overall treatment burden. Clinical studies and patient feedback suggest that Monovisc provides effective pain relief and improved joint function for up to six months. Many also report significant improvements in pain and mobility, with the benefits often noticeable within weeks of the injection.
As for patients undergoing Euflexxa treatment, they often report high satisfaction due to the progressive improvement seen over the three-week injection series. The gradual administration allows for a steady buildup of hyaluronic acid in the joint.
Clinical outcomes for Euflexxa show effective pain relief and enhanced joint function, with benefits typically lasting up to six months. Some patients may prefer the multiple-dose approach, which allows for gradual adaptation and monitoring of treatment efficacy.
Conclusion
Choosing between Monovisc and Euflexxa involves carefully considering their benefits and drawbacks. Both treatments offer significant relief from knee osteoarthritis pain by introducing hyaluronic acid directly into the knee joint through viscosupplementation, which improves mobility and reduces discomfort.
Monovisc might appeal to patients due to its single-injection regimen, while Euflexxa is notable for its proven effectiveness in pain management and enhancing joint function across various studies. Ultimately, the decision should be based on a patient’s health needs, lifestyle, and medical advice from healthcare professionals.
FAQs
1. What is the main difference between Monovisc and Euflexxa?
Monovisc and Euflexxa differ in composition, effectiveness, side effects, and cost.
2. Is one more effective than the other?
The effectiveness of Monovisc versus Euflexxa can vary depending on individual patient needs and responses to treatment.
3. Are there any common side effects associated with these treatments?
Yes, both Monovisc and Euflexxa may cause side effects such as pain or swelling at the injection site.
4. Which one is more cost-effective?
The cost-effectiveness of either Monovisc or Euflexxa depends on factors such as insurance coverage, dosage required, and frequency of injections needed.
References
World Health Organization. (n.d.). Osteoarthritis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/osteoarthritis
Drugs.com. (n.d.). Compare Euflexxa vs Monovisc. Retrieved from https://www.drugs.com/compare/euflexxa-vs-monovisc
McElheny, K., Toresdahl, B., Ling, D., Mages, K., & Asif, I. (2019). Comparative Effectiveness of Alternative Dosing Regimens of Hyaluronic Acid Injections for Knee Osteoarthritis: A Systematic Review. Sports health, 11(5), 461–466. https://doi.org/10.1177/1941738119861545
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