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Last Updated On: June 7, 2024

Orthovisc vs. Monovisc: Comparing Treatments

Published on: Jun 7, 2024

Knee osteoarthritis affects millions worldwide, causing pain, stiffness, and reduced mobility. As the population ages, the demand for effective treatments grows. Two commonly used options are Orthovisc and Monovisc, which aim to alleviate symptoms and improve patientā€™s quality of life.

Orthovisc and Monovisc are viscosupplements, injectable treatments that provide lubrication and cushioning to the knee joint. They are particularly useful for patients who have not responded well to other therapies or wish to delay surgery. These treatments can help reduce pain, improve joint function, and enhance overall well-being.

In this article, we will explore the differences between Orthovisc and Monovisc, including their efficacy, administration guidelines, and potential benefits, focusing on its use and limitations.

Key Takeaways

  • Orthovisc and Monovisc are hyaluronic acid injections, but Orthovisc is made from avian-derived hyaluronic acid, while Monovisc uses a fermentation process to create hyaluronic acid from bacteria.
  • Orthovisc is given as a three-injection series, one week apart, while Monovisc is a single injection.
  • Monovisc requires just one visit to the doctor, while Orthovisc involves three separate appointments over three weeks.
  • Insurance coverage may vary. Orthovisc is often covered, but Monovisc may not be.
  • Both treatments have shown similar efficacy in providing pain relief for osteoarthritis. However, the side effects may differ, with some patients experiencing pain or swelling after the injections.

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Understanding Orthovisc and Monovisc

Orthovisc and Monovisc are intraarticular hyaluronic acid injections that alleviate knee pain from osteoarthritis. Derived from rooster combs, Orthovisc typically requires three to four shots, while Monovisc offers the convenience of a single injection made through bacterial fermentation. Both aim to reduce pain and improve joint function, offering an alternative or addition to standard care like exercise or pain medications. 


Orthovisc and Monovisc provide significant symptom relief, potentially delaying more invasive procedures like surgery. The choice between Orthovisc’s multiple doses and Monovisc’s single dose often depends on patient preference, treatment goals, and specific medical advice. Orthovisc and Monovisc offer different paths for treating knee osteoarthritis, providing much-needed relief and support in the fight against this condition.

Formulation Differences

In the ongoing quest to provide the most effective treatments for knee osteoarthritis, medical professionals continuously scrutinize and compare options like Orthovisc and Monovisc. These treatments, both utilizing hyaluronic acid (HA), stand out due to their differing approaches to viscosupplementation. Let’s look closer at the composition and molecular weight of the hyaluronic acid in these two products, shedding light on how these factors play into their clinical efficacy.

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TreatmentSource of HAInjection FrequencyMolecular Weight
OrthoviscRooster combs3-4 injectionsHigh
MonoviscBacterial fermentationSingle injectionComparable to Orthovisc

Impact of Formulation Differences on Clinical Efficacy

Orthovisc and Monovisc differ in their formulations and dosing schedules. Orthovisc, derived from rooster combs, requires 3-4 shots, whereas Monovisc, produced through bacterial fermentation, requires only one injection. 

Despite both containing hyaluronic acid, Monovisc delivers a single high dose, offering faster relief with fewer injections. The source of hyaluronic acid may influence treatment outcomes, guiding doctors in choosing the most suitable option for each patient.

Clinical Efficacy of Both Treatments

Studies show that Orthovisc and Monovisc help people with knee pain caused by osteoarthritis. In research, patients getting these treatments felt less pain and moved better. Orthovisc needs 3-4 shots; Monovisc just one. This could make a big difference in choosing what’s best for someone.


Feedback from users gives Monovisc an average rating of 5.8 out of 10 based on 64 ratings on, where nearly half reported positive experiences. Also, a trial called Cingal 13-01 looked at how well Monovisc worked when mixed with another medicine, showing the combinations doctors can use to help patients more effectively. 

After completing three Orthovisc injections for osteoarthritis in her left knee, MaryK, a 68-year-old lifelong runner, experienced significant pain relief. While she had to give up running, Orthovisc allowed her to resume hiking, biking, and working out at the gym without discomfort.

For the past four years, John has been receiving injections for his knee pain. Previously, he relied on a brace and struggled with mobility. Thanks to the injections, he experienced significant improvement, avoiding the need for invasive procedures. Although he doesn’t have bone-on-bone arthritis, the injections have been life-changing for him.

Each option can ease knee problems and improve the quality of life for those suffering from this common condition. Orthovisc and Monovisc offer effective relief, allowing patients to enjoy a better quality of life, even without surgery. 

Patient Outcomes and Symptom Relief Associated with Each Treatment

Orthovisc and Monovisc provide long-term relief from knee pain due to osteoarthritis, helping patients move more comfortably. While Orthovisc requires three to four shots, Monovisc offers relief with just one. Both contain hyaluronic acid but from different sourcesā€”rooster combs for Orthovisc and bacteria for Monovisc. 

Side effects from Orthovisc or Monovisc injections are typically mild, including pain, swelling, or warmth at the injection site, but allergic reactions are possible, especially with Orthovisc. Close patient monitoring is crucial after treatment.

Dosing Regimens

Depending on the patient’s needs, Doctors decide how much and when to give Orthovisc or Monovisc.Orthovisc and Monovisc are two options for treating knee pain caused by osteoarthritis. They use hyaluronic acid to help the knee move smoothly.

For Orthovisc:

  • Patients get a series of three to four shots.
  • These shots are given one week apart.
  • Each shot contains hyaluronic acid from rooster combs.
  • This treatment is spread over several weeks.

Monovisc has a different approach:

  • Only one shot is needed.
  • It uses hyaluronic acid made through bacterial fermentation.
  • The single shot provides as much hyaluronic acid as the Orthovisc shots combined.

Choosing the Right Treatment

Choosing between Orthovisc and Monovisc involves understanding their unique features. Here are key points to help medical professionals decide which treatment might fit better for their patients with knee osteoarthritis.

  • Number of Injections Needed: Orthovisc requires three to four shots, depending on the prescribing information. For patients who prefer fewer doctor visits, Monovisc, with its one-shot schedule, might be a better option.
  • The Hyaluronic Acid Source (HA) from Rooster Combs: This could concern patients with bird protein allergies. Monovisc uses HA from bacterial fermentation, possibly making it a safer choice for these individuals.
  • Patient’s Pain Tolerance and Time Availability: Some may find multiple injections uncomfortable or not have the time for several appointments. 
  • Clinical Outcomes: It is essential to examine how each treatment has worked in studies and trials. Both treatments effectively manage knee osteoarthritis symptoms, but individual patient results vary.
  • Potential Side Effects: Both options carry risks of side effects, such as pain at the injection site or swelling. Knowing a patient’s history of reactions can guide the choice. 
  • Long-term Benefits: Consider what is known about how long symptom relief lasts after treatment with either option. Discuss these aspects with patients, so they have realistic expectations about the outcomes.
  • Overall Health and Medical History: Patients with specific health conditions may respond better to one treatment. This includes considering any allergies or sensitivities to components used in either Orthovisc or Monovisc.
  • Patient Preference: Lastly, after discussing all factors, some patients might have a personal preference. Their comfort and confidence in their treatment choice are crucial for a positive outcome.

Expert recommendations and guidelines for decision-making

Doctors often choose between Orthovisc and Monovisc for knee osteoarthritis, considering patient health, arthritis severity, and treatment preferences. Monovisc’s single injection offers convenience, while Orthovisc, requiring 3 to 4 shots, appeals to some due to its natural sourcing. 

Experts advise thorough patient assessment, considering past reactions and allergies. Both treatments effectively alleviate knee pain, so personal preference and practicalities often dictate the choice. Stay updated on evolving guidelines and research for the most current treatment options.


Choosing between Orthovisc and Monovisc comes down to patient needs and doctor advice. Both treatments offer relief for knee osteoarthritis but in different ways. Orthovisc requires more shots, while Monovisc does the job with just one.

Results from both can significantly improve patients’ lives. So, doctors consider what works best for each person before deciding. This makes picking the right option a careful choice based on many factors.


1. What’s the difference between Orthovisc and Monovisc?

Orthovisc and Monovisc are both treatments for knee pain, but they have differences. Orthovisc typically requires multiple shots, while Monovisc often works with just one injection.

2. Is Orthovisc a type of steroid?

No, Orthovisc is not a steroid. It’s a lubricant for knee joints, helping them move smoothly and easing pain without steroids.

3. Can getting an Orthovisc shot hurt me?

There can be side effects like any treatment, but they’re rare. You might experience some swelling or soreness at the injection site, but these effects are usually mild and temporary.

4. How do I know if I should choose Orthovisc or another option like Synvisc or Euflexxa?

Your doctor will determine your best option based on your condition. Since each person’s situation differs, your doctor will consider what makes the most sense for you.

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Cueto I. Common injections donā€™t help knee osteoarthritis more than placebo, large data review finds. STAT. Published July 6, 2022. Hyaluronan Injections for Knee Osteoarthritis. WebMD.