Synvisc is known for their orthopedic injectable solutions, Synvisc and Synvisc-One (hylan G-F 20). This injectable viscosupplement belongs to the group of “synovial fluid replacements” or medications used to relieve osteoarthritis’ symptoms. Osteoarthritis is the most common type of arthritis, and is characterized by stiff and painful joints due to degeneration of the protective cartilage in the ends of the bone. Patients with osteoarthritis are also found to have thinner synovial fluid in their joints, which decreases its ability to lubricate the joints. Synvisc mimics the body’s own synovial fluid to help lubricate and cushion the affected joints.
Synvisc treatments are highly popular around the world, including countries such as Canada, UK, Australia and the UK.
Osteoarthritis often affects individuals in their mid-to-late 40s, but this treatment can be given to younger patients. Synvisc is recommended as a second-line therapy to patients suffering from joint pain and stiffness in their knees caused by osteoarthritis. Patients, who have not received relief from diet, exercise, and over-the-counter pain relievers may benefit from this treatment.
This should not be given to patients, who are allergic to hyaluronic acid, eggs, poultry, and other avian-derived products. Patients with severely swollen joints, skin infection near the affected area, and lymphadenopathy should not receive this treatment. Synvisc is not tested in patients under the age of 21, as well as in pregnant and nursing women.
One of the characteristics of osteoarthritis is the deterioration of cartilage in the joints. The cartilage acts as a protective cushion to permit almost frictionless joint motion. In osteoarthritis, the cartilage deteriorates and becomes rough. Loss of cartilage will result to the rubbing of bones during motion, and patient may experience pain, stiffness, tenderness, loss of flexibility, and a grating sensation while moving the joint involved.
To lubricate the affected joint and act as a shock absorber, Synvisc is injected into the synovial space. Synvisc contains the cross-linked hyaluronic acid derivative, hylan G-F 20, an FDA-approved treatment for knee osteoarthritis since 1997.1 Hyaluronic acid or hyaluronan can be found in large amounts in joints. Synvisc is an elastic and gel-like fluid that helps the bone move smoothly. This improves the patient’s mobility and decreases pain in the affected area.
The solution is injected directly into the synovial space of the affected joint. The maximum recommended dose for Synvisc injections is 6 injections within 6 months. A numbing agent can be given to relieve pain in the injection area. Synvisc can be administered to both knees during the same treatment time. Most patients experienced pain relief with just one dose, but 3 injections may provide the maximum benefit. Patients must be advised to avoid prolonged weight-bearing activities for at least 48 hours after the injection.
Patients may not experience pain relief immediately. After a set of 3 injections, patients may experience pain relief for up to 6 months. This injectable solution was tested against saline solution in a 26-week controlled trial, and found to give dramatic early improvement to patients with osteoarthritic knee.3 From the hylan G-F 20 group, up to 56% of patients experienced pain relief for 10 to 24 weeks after the last injection.
Patients must be monitored for possible signs of allergic reaction, such as hives, swelling of the face, lips, or tongue, and difficulty of breathing. Inform patients about the common side effects, which may include:
Patients can resume their normal daily activities after the injection, but activities that put excessive strain on the knees must be avoided up to 48 hours. If swelling or pain is felt at the injection site, recommend placing an ice pack for 10 minutes.
One dose of Synvisc can range from $750+. Treatment can be repeated safely. Patients who prefer fewer injections can be given Synvisc-One. This drug contains the 3 doses (48 mg) of hylan G-F 20. Both can provide pain relief for up to 6 months.
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