Viscosupplementation: Choosing the Right Product is Crucial
Hyaluronic acid joint injections are not all the same. Molecular weight, degree of cross-linking, concentration, volume, and additives determine which preparation is best suited for which patient and which joint. This guide provides physicians and orthopedic surgeons with a structured decision-making aid.
Single-Shot Preparations: One Injection, Maximum Compliance
For patients with limited time or needle phobia, single-shot preparations are the first choice.
Durolane 60mg/3ml – NASHA® technology from Bioventus. The only NASHA® single injection approved for knee and hip. Duration of action up to 6 months. First choice for gonarthrosis and coxarthrosis without acute inflammation.
Synvisc-One 48mg/6ml – Hylan G-F 20 from Sanofi. Chemically cross-linked HA with superior viscoelastic properties. Over 20 years of clinical evidence. Duration of action up to 6 months.
Monovisc 88mg/4ml – Highest total HA amount (88 mg) among single-shots. Ideal for knee osteoarthritis with a desire for maximum HA dose.
HyalOne 60mg/4ml – Natural HA, medium volume. Well tolerated, even in patients prone to allergies.
Cingal 4ml – The only combination of HA + triamcinolone acetonide. Immediate pain relief through corticosteroid + long-term effect through HA. First choice for knee osteoarthritis with an acute inflammatory component.
Multiple Injection Series: Cumulative Effect
For patients who prefer gradual therapy or for whom single-shots are not sufficiently effective.
Ostenil Plus 40mg/2ml – Highly concentrated HA with mannitol antioxidant. 3–5 injections, duration of action up to 9 months. Particularly effective in inflammatory osteoarthritis.
Ostenil 20mg/2ml – Classic preparation for the 3–5 injection series. Proven, well-tolerated, suitable for all major joints.
Orthovisc 30mg/2ml – High molecular weight HA (1,000–2,900 kDa), series of 3. Good value for money.
Hyalubrix 30mg/2ml – High molecular weight HA for optimal viscoelastic properties. Series of 3.
Specialized Preparations
Ostenil Mini 10mg/1ml – Specifically for small joints (fingers, toes, facet joints). Reduced volume for precise application.
Ostenil Tendon 40mg/2ml – The only CE-certified HA preparation specifically for tendon disorders. Peritendinous injection.
Decision Aid: Which preparation for which situation?
| Situation | Recommendation |
|---|---|
| Knee osteoarthritis, no inflammation, single-shot desired | Durolane 60mg/3ml |
| Knee osteoarthritis with acute inflammation | Cingal 4ml |
| Hip osteoarthritis, single-shot | Durolane 60mg/3ml |
| Knee osteoarthritis, highest HA dose desired | Monovisc 88mg/4ml |
| Advanced osteoarthritis, multiple series | Ostenil Plus 40mg/2ml |
| Small joints (fingers, toes) | Ostenil Mini 10mg/1ml |
| Tendon disorders (tennis elbow etc.) | Ostenil Tendon 40mg/2ml |
Conclusion
The choice of the right hyaluronic acid preparation is a clinical decision that takes into account the patient's profile, joint, degree of osteoarthritis, and treatment goal. At Novamedo, you will find the complete range – CE-certified, MDR-compliant, at competitive B2B prices.
