Single-Shot Injections for Knee Osteoarthritis: Why Single-Shot?
Viscosupplementation with hyaluronic acid has established itself as an effective therapy for knee osteoarthritis. Single-shot injections offer crucial advantages: higher patient compliance, fewer doctor visits, and often better cost-efficiency. The three leading preparations – Durolane®, Monovisc® and Cingal® – differ in active ingredient, concentration, and mechanism of action.
Durolane® 60mg/3ml – NASHA® Technology
Durolane® 60mg/3ml from Bioventus is the only approved NASHA® single-shot injection for knee and hip osteoarthritis.
- Active ingredient: NASHA® hyaluronic acid (20 mg/ml)
- Volume: 3 ml | Duration of action: 6–12 months
- Special feature: Only NASHA® Single-Shot – highest stability & purity
Monovisc® 88mg/4ml – Highest Total HA Content
Monovisc® 88mg/4ml from Anika Therapeutics is a highly cross-linked hyaluronic acid single-shot injection with the highest total HA content among single-shot preparations.
- Active ingredient: Highly cross-linked HA (22 mg/ml)
- Volume: 4 ml | Duration of action: Up to 6 months
- Special feature: Highest total HA content (88 mg) among single-shots
Cingal® 4ml – HA + Corticosteroid
Cingal® 4ml from Anika Therapeutics is the only joint injection that combines highly cross-linked hyaluronic acid with triamcinolone acetonide – for immediate and long-lasting effect.
- Active ingredients: HA (22 mg/ml) + triamcinolone acetonide (18 mg)
- Volume: 4 ml | Duration of action: HA up to 6 months + immediate corticosteroid effect
- Special feature: Only combination of HA + corticosteroid on the market
Direct Comparison: Durolane® vs. Monovisc® vs. Cingal®
| Feature | Durolane® | Monovisc® | Cingal® |
|---|---|---|---|
| Manufacturer | Bioventus | Anika Therapeutics | Anika Therapeutics |
| HA Technology | NASHA® | Highly cross-linked | Highly cross-linked |
| HA Content | 60 mg | 88 mg | 88 mg |
| Volume | 3 ml | 4 ml | 4 ml |
| Corticosteroid | No | No | Yes (Triamcinolone) |
| Immediate effect | No | No | Yes (Corticosteroid) |
| Duration of action | 6–12 months | Up to 6 months | Up to 6 months |
| Indication | Knee & Hip | Knee | Knee (with inflammation) |
When to use which single-shot injection?
- Durolane®: First choice for knee and hip osteoarthritis without acute inflammation – longest duration of action (6–12 months).
- Monovisc®: Ideal for knee osteoarthritis with a desire for the highest total HA content.
- Cingal®: First choice for knee osteoarthritis with an acute inflammatory component.
