Arthritis affects many people. The root cause of the disease is degeneration of the joints and loss of cartilage and joint fluid. Joint fluid lubricates the joints, stopping them from rubbing together painfully and causing further degeneration of cartilage. The loss of joint fluid, which is common in aging, can cause considerable pain. However, in recent years replacement joint fluid (hyaluronic acid) has become available as an effective treatment option. Currently these are only approved for standard use in the knee, but it is believed that they can help postpone knee replacement, or serve as an alternative when knee replacement is not an option.
The joint replacement fluid is injected into the knee as a minor office procedure. Generally one injection is given once a week for a few weeks. Both knees can be done at the same time. The treatment can be repeated as soon as six months, or when needed, with the hope that the treatment will last that long or longer. You should avoid strenuous exercise such as jogging for 48 hours after your injection.
The products (except euflexxa) are manufactured by purifying a chemical in rooster comb. If you are allergic to eggs, bird feathers, or bird proteins, then euflexxa is the only brand you should consider. Also, since they contain products derived from animals, euflexxa may not be appropriate for vegetarians and vegans who are concerned about animal products in their medications. Infection or skin disease at the injection site should be avoided. It is not known if there are risks for pregnant or nursing mothers.
Complications are rare. If you have symptoms of a serious allergic reaction (hives, difficulty breathing, closing of the throat, swelling), you should seek help immediately. There is a risk of joint infection, but this appears to be very rare. There is debate whether a condition can occur in which the knee becomes very swollen and painful, such that it appears infected, but is not infected - a sydrome being referred to as a pseudoseptic joint. Only synvisc is suspected of possibly causing this condition, and some debate whether the condition occurs at all.
Synvisc is the biggest seller in the United States. It is given in 3 injections over three weeks. Synvisc is unique in that it's hyaluronic acid is "cross-linked." Some argue that this brand can sometimes cause a painful swollen joint, referred to as pseudoseptic joint, while other brands don't. Others claim that it does not cause this condition and that it is the most effective of the preparations.
Synvisc-One is another joint replacement therapy option. It is the same chemical preparation as synvisc, but at a higher dose and can be given as a single injection, instead of a series of 3.
Supartz has been used more worldwide than any other hyaluronic acid. It requires five injections.
Hyalgan appears to be the same product as supartz, sold by a different company.
Euflexxa is unique in that it is the only brand that should be used in patients with bird allergies (particularly rooster or egg). It is manufactured in a different manner, that does not involve rooster comb. It requires three injections.
Visit these medications' websites for more information: Synvisc Synvisc-One Supartz Euflexxa
Another useful review is here.
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