Synvisc vs Cortisone: Osteoarthritis Treatment

Synvisc vs Cortisone

Treating Osteoarthritis: Synvisc vs Cortisone

What are the treatment methods for osteoarthritis?

Osteoarthritis (OA) is a long-term inflammatory disease that affects the synovial joints. This degenerative disease is usually seen in patients who are overweight, have a family history of OA, have weak thigh muscles, and/or have had previous joint injuries. Under normal circumstances, the synovial joint is made of two bones that are covered with a tough and protective articular cartilage. This cartilage secretes lubricating synovial fluid that helps the bones to glide against each other effortlessly and absorb sudden shocks. However, with OA, this cartilage disintegrates, causing symptoms like pain, heat, swelling, stiffness, and reduced joint flexibility.

Most patients who are diagnosed with OA will be treated with a combination of pharmacological and non-pharmacological methods, depending on the severity of the condition. One efficient pharmacological method is cortisone administration. Cortisone, also known as corticosteroid, is a powerful anti-inflammatory steroid medication that reduces pain and inflammation by reducing the activity of the immune system and the production of inflammatory mediators. When patients do not respond well to medications and non-pharmacological approaches—which can include lifestyle modifications, weight reduction (if necessary), rehabilitation program(s), and assistive devices, to name a few—they may be advised to undergo viscosupplementation instead. This medical procedure involves injecting the affected joint with viscoelastic gel that simulates the action of synovial fluid, thereby restoring joint health and performance.  

What are the similarities between Synvisc and Cortisone?

While there are numerous brands of orthopedic implants on the market, Synvisc, a viscosupplement made by Sanofi Genzyme, is a renowned brand that has been used for more than two decades. This brand of intraarticular implant and cortisone do share some similarities in their clinical properties, as detailed below:

  1. Administration technique:Both viscosupplements are designed to administering via an intraarticular injection into the synovial space within the affected joint. However, this medical procedure should only be done by a licensed and skilled healthcare specialist. Most importantly, the procedure must abide by standard aseptic guidelines in order to reduce the risk of infections and other undesirable side effects.

What are the differences between Synvisc and Cortisone?

Despite their similarities, Synvisc and Cortisone are extremely different in other aspects, as detailed below:

  • Active ingredient: Synvisc is made of two polymers: Hylan A, which has a fluid-like consistency, and Hylan B, which has a gel-like consistency. These hylan polymers are actually derivatives of hyaluronan that are extracted from the fleshy crests on top of rooster heads, which are often referred to as rooster combs. The hylan polymers are then extensively purified before they are chemically cross-linked with each other, resulting in an elastoviscous high molecular weight fluid. These rheological properties make the Synvisc gel closely mimic the properties of healthy synovial fluid. As for cortisone injections, it can consist of different classes of steroid, such as triamcinolone and hydrocortisone, depending on the severity of the OA condition.

  • Mechanism of action: Synvisc is an orthopedic implant that is intended to mimic the activity of synovial fluid. Once administered into the synovial space, it allows the bones to glide against each other with lesser friction, which results in less pain. The injected hylan gel also absorbs shock in order to delay the progression of OA. On the other hand, Cortisone mimic the effects of the hormone cortisol, which is produced by the adrenal grands. This hormone downregulates the severity of inflammation by reducing the production of prostaglandins and the interaction between some immune cells, including B-cells and T-cells. Cortisone injection will then reduce the symptoms associated with OA, such as pain, swelling, heat, and stiffness.

  • Duration of action: A complete treatment course using Synvisc involves injecting the affected joint three times, with each injection session spaced one week apart. Patients will notice improvements to their condition about a month after the completion of the treatment session. These desirable effects should last for about six months before the gel is completely resorbed into the surrounding tissues, resulting in the return of OA symptoms. On the contrary, Cortisone injections are only able to deliver pain-relieving effects for a maximum of two months before patients start noticing the painful and debilitating symptoms of OA again.

  • Types of contraindicated patients: Synvisc is a safe and effective orthopedic implant, and its quality has been reviewed in various quality analysis tests and clinical trials. Patients’ testimonials further attest to the safety profile of this viscosupplement. That being said, Synvisc is still contraindicated in the following patients due to unestablished safety profiles:

    • Patients who are hypersensitive to avian proteins;
    • Patients with skin disorders, such as inflammations and/or infections at the proposed treatment area;
    • Patients with severely inflamed joints;
    • Patients who are pregnant;
    • Patients who are nursing their children;
    • Patients who are below 12 years of age.

On the other hand, Cortisone injection the following list of contraindications:

  • Patients with an underlying illness, such as bacteremia and sepsis;
  • Patients with whose joints are severely inflamed and/or infected;
  • Patients with skin disorders, such as inflammations and/or infections at the proposed treatment area;
  • Patients who are allergic to previous cortisone injections;
  • Patients with acute injuries, such as broken bones and head trauma.

  • Possible side effects: Following treatment session using Synvisc, patients may develop certain side effects, including pain, swelling, and fluid buildup around the treated joint. On the other hand, Cortisone injection can result in side effects such as pain; temporary bruising; flushing of the face; whitening of skin around the injection site, which is fairly quite common among dark-skinned individuals; softening of cartilage; and the weakening of the tendon at the injection site.
  • Cost of treatment: The estimated cost of the complete treatment course for Synvisc is $1272.70. As for Cortisone, each injection could cost anywhere between $100 to $300. Nevertheless, both these treatment methods are covered by many insurance plans.  

Note on articles: These articles are not endorsed by DoctorMedica nor reviewed for medical accuracy. Similarly, views and opinions expressed are those of the author only. Articles are meant for informational purposes only. Ask your doctor for professional medical advice.


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