Unfortunately, these treatments may not be sufficient for relieving the discomfort in all patients. When non-surgical treatments fail to provide adequate relief, a knee replacement surgery may be considered. Knowing when the timing is right to have a knee replacement can be a difficult decision to make. Synvisc is a treatment that is intended to relieve the symptoms of knee arthritis and delay the need for knee replacement surgery.
How does Synvisc work?Synvisc an injectable medication called hyaluronan. Injectable hyaluronan is often referred to by its most commonly known brand name of "Synvisc." Other brand names of hyaluronan include Orthovisc, Euflexxa, and Supartz.
Synvisc is typically administered as a series of three injections into the knee joint, each injection spaced about one week apart. Synvisc has been shown to help alleviate arthritis symptoms for 6 months, and to delay the need for knee replacement surgery.
Hyaluronan, the name of the substance in Synvisc, is present in normal joint fluid and responsible for the lubricating properties of normal joint fluid. The lubricating effects of joint fluid allows for the cartilage surfaces of joints to glide upon each other in a smooth fashion. By injecting Synvisc into a knee joint, some people consider this a so-called joint lubrication. This is why you may hear of Synvisc as a 'motor oil' for the knee joint. Hyaluronan has also been shown to have anti-inflammatory properties, and may help protect remaining cartilage in the joint.
Does Synvisc actually help knee arthritis?Numerous studies have investigated the effectiveness of Synvisc as a treatment for knee arthritis. Studies have ranged in their results from no benefit when compared to placebo injections, to significant pain relief for 6 months from the time of the injections. However, no clear understanding of how well Synvisc injections perform has emerged. Most orthopedic surgeons will agree that there is likely a temporary benefit of Synvisc injections, but in the long-term, additional treatments are likely to be necessary.
Should I have a Synvisc injection?So where does this leave patients? No study has shown that Synvisc injections are an effective treatment in a large number of patients over a long (more than one year) length of time. That said, Synvisc injections have been shown to be of temporary benefit in some patients. Most promising are studies demonstrating that Synvisc injections delay the need for knee replacement in patients with severe arthritis.
Furthermore, no study has found serious adverse side effects associated with the use of Synvisc injections in the knee joint. When reactions to Synvisc injections occur, they tend to be flare-ups of knee inflammation, that usually settle down within a few days. These flare-up reactions occur in about 3% of all injections of Synvisc. Therefore, treatment has been shown to be safe, and there is potential that patients can find pain relief from Synvisc injections.
Strauss EJ, et al. "Hyaluronic Acid Viscosupplementation and Osteoarthritis: Current Uses and Future Directions" Am J Sports Med. 2009 Feb 3.
Watterson JR, and Esdaile JM. "Viscosupplementation: Therapeutic Mechanisms and Clinical Potential in Osteoarthritis of the Knee" J. Am. Acad. Ortho. Surg., September/October 2000; 8: 277 - 284.
Lohmander, L, et al. Intra-articular hyaluronan injections in the treatment of osteoarthritis of the knee: a randomized, double blind, placebo controlled multicentre trial. Annals of Rheumatic Diseases. 55:424-431. 1996.