Monovisc vs. Synvisc – Comparing Knee Treatments

Knee osteoarthritis is a prevalent condition that has led to significant healthcare interventions. In 2021 and 2022, over 53,500 knee replacements were performed in Australia alone as a treatment for osteoarthritis. However, those who do not want to undergo invasive procedures like surgery turn to viscosupplementation.

Two of the most popular knee injections are Monovisc and Synvisc. Comparing these two hyaluronic acid-based treatments for knee osteoarthritis is crucial for understanding their efficacy and suitability for different patients. Both aim to relieve pain and improve joint function but differ in composition and treatment protocols.

This article will delve into the similarities and differences between these two treatments, providing insights to help patients and practitioners make informed decisions.

Key Takeaways

• Monovisc needs just one shot for knee pain, making it simpler and quicker. Synvisc requires three shots over several weeks but works on more than knees.
• Both treatments use a substance like natural joint fluid to help with osteoarthritis pain and improve joint movement.
• Studies show both Monovisc and Synvisc reduce knee pain effectively, but patient experiences may vary.
• Choosing between them depends on things like how often you’re okay with getting shots and if your pain is in places other than the knee.
• Before deciding, talk to a doctor about the best treatment based on your health needs.

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Introduction to Monovisc and Synvisc

Knee osteoarthritis (OA) is a common issue in which the cartilage in the knee wears down over time. This process can lead to pain, stiffness, and difficulty moving. People seek treatment to ease their symptoms and improve their quality of life.

Monovisc and Synvisc stand out in this field. Viscosupplementation reduces pain, improves function, and may delay the need for surgery in treating knee osteoarthritis.

Comparing Monovisc and Synvisc is critical because they treat knee osteoarthritis differently. Monovisc, mainly for the knee, needs just one shot. Conversely, Synvisc works in knees, shoulders, hips, and ankles but requires three shots over weeks.

Composition and Mechanism of Action

Monovisc stands out as a single-dose treatment option for knee osteoarthritis. Made from hyaluronic acid, it mimics the body’s natural joint fluid. This similarity helps lubricate and cushion the knee joint, relieving pain and improving mobility.

Monovisc mimics the natural hyaluronic acid found in healthy joint fluid. When injected into a knee joint affected by osteoarthritis, It enhances lubrication and cushioning. This increased viscosity reduces friction between the articular cartilage, alleviating pain and improving joint mobility. 

The single-dose injection provides sustained relief by maintaining enhanced viscosity and cushioning over time, thus supporting long-term joint health and function.

Meanwhile, Synvisc comprises Hylan G-F 20, a mixture of hylan A and hylan B polymers. Hylans are derivatives of hyaluronan, but they are chemically cross-linked to provide greater elasticity and viscosity than naturally occurring hyaluronic acid. This composition gives Synvisc its unique viscoelastic properties.

Synvisc supplements the synovial fluid within the joint, enhancing its lubricating and shock-absorbing properties. Synvisc forms a protective layer over the articular cartilage when injected, reducing friction and mechanical stress on the joint. This action helps relieve pain and improve the range of motion in joints affected by osteoarthritis.

Synvisc typically requires a series of three injections over three weeks to achieve optimal results, providing cumulative benefits with each dose.

Key Differences Between Monovisc and Synvisc

Both Monovisc and Synvisc are designed to mimic the natural properties of synovial fluid to alleviate the symptoms of osteoarthritis, but they differ in their composition and administration.

• Monovisc utilizes high molecular weight hyaluronic acid and is administered as a single-dose injection, offering convenience and sustained relief.
• In contrast, Synvisc uses a cross-linked hyaluronan derivative (Hylan G-F 20) requiring three injections, which can treat multiple joints beyond the knee, such as the shoulders, hips, and ankles.

These treatments provide effective options for managing osteoarthritis pain, with Monovisc offering a more straightforward, one-time treatment and Synvisc providing versatile, multi-joint applications.

Clinical Efficacy

Clinical trials show that both Monovisc and Synvisc greatly help with knee osteoarthritis pain.

• Clinical data suggests that Monovisc delivers a 65% improvement in WOMAC pain at Week 26 relative to baseline and provides long-lasting pain relief for up to 6 months. 
• As for Synvisc, clinical trials demonstrate its effectiveness in reducing pain and improving function in knee OA patients. 

Real-world Experiences and Patient Outcomes

Doctors see Monovisc and Synvisc as helping many people with knee pain from osteoarthritis. Patients often feel less pain after these treatments. Monovisc, given in one shot, makes it easier for some folks.

• “I had my first Monovisc injection in September 2019, my second was due in March 2020, and then COVID hit. Finally able to have injections for the second time in May 2020. These injections have been great for both knees. I am bone on bone in my right knee. I went to two different Orthopedic Surgeons before having the injections. Both recommended getting them, and I am so happy I did. No pain, no issues with the injections, and they help! I will continue with the Monovisc injections until I can’t have them or they don’t work. Both surgeons said I can continue these until they don’t work; some patients continue and never need knee replacement. Wouldn’t that be great? It’s a big yes vote from me.”
• “I have mild to moderate osteoarthritis in my right knee from an ACL reconstruction in 2000 and menisectomy in 2016 to clean up meniscal tears. I have been using Synvisc One for over two years, and it has been very effective. It takes me from having a stiff, painful knee to a nearly fully functional joint on which I can train and do fairly high-impact sports. It takes a week or 2 to kick in after an injection. The knee feels stiff and achy at first, but it eases up, and within a month, you forget you ever had OA. You add 6 ml to the 6 ml already in your knee joint capsule with the single injection. No wonder it feels full at first. Rest and give it a week or so to blend in. I am 56 and surf nearly every day. Synvisc-One is the miracle solution that keeps my knee pain-free and functional. I highly recommend it.”

Practical Considerations

When choosing Monovisc or Synvisc for knee treatment, it’s critical to consider doses and how each is given. Find out more to make the best choice.

Dosing Schedules for Monovisc

Monovisc offers a simple treatment plan for knee osteoarthritis. It is administered as a single-dose injection directly into the knee joint.

• Monovisc stands out because it requires only one shot. This process is different from many other treatments that need multiple injections.
• Patients receive the total dose of hyaluronic acid in this one sitting. Hyaluronic acid helps lubricate and cushion the knee joint.
• The ease of a single injection makes scheduling more convenient for both patients and healthcare professionals. There’s no need to set up several appointments.
• Compared to Synvisc, which requires three weekly injections, Monovisc’s one-and-done approach saves time and reduces patients’ discomfort.
• After getting a Monovisc injection, patients can usually return to their daily activities quickly. They should avoid heavy activities for about 48 hours. While Monovisc’s side effects include joint or back pain, they usually go away on their own.
• It can take some time for patients to feel relief after the injection. Everyone reacts differently, but many report feeling better within a few weeks.

Dosing Schedules for Synvisc

Synvisc requires a specific approach for its administration to patients. The treatment involves three injections spaced one week apart.

• First Visit: Patients receive their initial Synvisc injection directly into the knee joint. Healthcare professionals use sterile techniques to ensure safety and effectiveness.
• Second Visit: Patients return for their second dose one week after the first injection. This follow-up is crucial for building upon the effects of the initial dose.
• Third Visit: Another week later, the final Synvisc injection is administered. Completing this series is essential for achieving the full benefit of the treatment.
• Post-treatment Care: After receiving all three injections, patients might be advised to avoid strenuous activities for a short period to allow the knee to adjust.
• Monitoring and Follow-up: Healthcare providers usually schedule follow-up appointments to assess the effectiveness of the treatment and discuss any concerns.

Administration Techniques

We focus on the administration techniques for Monovisc and Synvisc. Here’s a look at how Monovisc and Synvisc should be administered:

• Gather all necessary supplies, including the syringe, sterile gloves, antiseptic solution, and bandages.
• Have the patient in a comfortable position that allows easy access to the knee area.
• Clean the injection site on the knee thoroughly with an antiseptic solution to prevent infection.
• If numbing is needed, a small needle should be used to draw up a local anesthetic and inject it into the area around the knee.
• Carefully remove the cap from the syringe, ensuring not to touch the syringe tip or let it touch any non-sterile surfaces.
• Insert the needle attached to the syringe into the knee joint space. The correct entry point is crucial for efficacy.
• Slowly press down on the syringe’s plunger to deliver Monovisc into the knee joint space.
• Once the injection is complete, gently withdraw the needle and apply pressure with a sterile gauze pad if there’s any bleeding.
• Dispose of needles and syringes properly following your facility’s safety protocols.
• Advise patients what to do after injection, like avoiding heavy activities for 48 hours.
• Schedule a follow-up appointment or provide instructions on how patients can monitor their response to treatment over time.

Knowing the dosing schedules and administration techniques of Monovisc and Synvisc is vital for healthcare professionals. Monovisc requires only a single injection, making it more straightforward for doctors and patients.

Choosing the Right Treatment

Choosing the proper treatment for knee osteoarthritis or other joint conditions requires a detailed comparison of available options, such as Monovisc and Synvisc. These viscosupplementation treatments offer different approaches to managing pain and improving joint function. Below is a concise summary of the key distinctions:

Aspect	Monovisc	Synvisc
Prescribed Use	Mainly for knee osteoarthritis	Used for knees, shoulders, hips, and ankles
Dosing Schedule	Single-dose treatment	Three weekly injections
Composition	High molecular weight, cross-linked hyaluronan	The mixture of Hylan A and hylan B, derivatives of hyaluronan
Clinical Efficacy	Comparable dose to Synvisc but requires fewer injections	Effective for multiple joints beyond the knee
Real-world Patient Outcomes	Positive responses for knee treatments	Versatile implant with applications in various joints

Factors to Consider When Choosing Between the Two Treatments

Understanding the critical differences between Monovisc and Synvisc sets the stage for a deeper examination. Deciding on the proper treatment requires carefully weighing several factors.

• The specific joint needing treatment plays a vital role. Monovisc is primarily recommended for knee osteoarthritis, while Synvisc offers broader application across knees, shoulders, hips, and ankles.
• Consider the patient’s preference and ability to handle injections. Monovisc involves a single dose, making it more straightforward for those wary of multiple clinic visits. On the other hand, Synvisc requires three weekly injections.
• Assessing pain reduction outcomes from clinical trials can guide decision-making. Cingal has shown significant pain relief over Monovisc and saline in some studies within three weeks post-injection.
• Patients looking for fewer doctor visits might lean towards single-injection options like Monovisc or Synvisc-One due to their reduced dosing frequency compared to others requiring multiple shots.
• Efficacy is paramount; thus, reviewing data on how well each treatment alleviates pain and improves knee function is essential.

Conclusion

Choosing between Monovisc and Synvisc for knee pain depends on the patient’s needs and specific joint issues. Monovisc works well as a single shot for those focusing on knee problems.

Synvisc, which involves three shots, covers more ground, including shoulders and hips. Both treatments aim to ease pain and improve quality of life. So, discuss them with a healthcare professional to find which best suits your or your loved ones’ joint health journey.

FAQs

1. What’s the main difference between Monovisc and Synvisc?

Monovisc is a single injection treatment, while Synvisc might need three shots over several weeks.

2. How long do these treatments last?

Both can ease knee pain for up to six months. It’s pretty cool.

3. Are there any side effects with Monovisc or Synvisc?

Yes, both can cause discomfort, like swelling or pain at the injection site, but it’s usually mild.

4. Can I go back to normal activities after getting these treatments?

Sure thing! Take it easy for a couple of days.

5. Which treatment works faster for knee pain relief?

Monovisc often works quicker because it’s just one shot; Synvisc takes more time because it requires multiple injections.

References

Australian Institute of Health and Welfare. (n.d.). Osteoarthritis. Australian Institute of Health and Welfare. Retrieved June 24, 2024, from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis

Drugs.com. (n.d.). Synvisc-One: User reviews and ratings. Drugs.com. Retrieved June 24, 2024, from https://www.drugs.com/comments/hylan-g-f-20/synvisc-one.html

Drugs.com. (n.d.). Monovisc: User reviews and ratings. Drugs.com. Retrieved June 24, 2024, from https://www.drugs.com/comments/hyaluronan/monovisc.html