HYALGAN®

Hyalgan is a viscosupplement injectable filler designed for advanced treatment of knee osteoarthritis when other therapies have failed to provide adequate improvements. Fidia Pharma USA formulated this orthopaedic filler with highly viscous sodium hyaluronate (20mg/2mL) as the active component, hence its name. The packaging is differentiated by the number of syringes, which range from 1 to 5-2mL prefilled syringes as well as the product manual. However, needles are not included and must be obtained separately. The item is sterilised and must be kept in its original packaging, away from light and in a area with a temperature below 25℃. Do not freeze this orthopaedic filler gel.

Hyalgan can be used as a supplementary therapy or to replace therapies (e.g. weight loss, wearing mobility support like knee guards, oral painkillers, oral supplements) used to manage osteoarthritic pain of the knee joints. Sodium hyaluronate gel shares the same viscosity as the joint fluid between the bones within the knee joint. So, the bones are lubricated and prevented from painfully rubbing against each other. As a result, joint movements are slicker with very minimal pain.

The knee joint is one of the hardest-working joints in the body. Not only does it assist in movements, it also provides stability and supports the body’s weight. The joint itself can be categorised as a synovial joint since the thigh bone (femur) and shin bone (tibia) are encased within an elastic membrane and are separated by a layer of cartilage and synovial fluid. Articular cartilage is a thin yet resilient tissue that enables bones to glide over each other easily. The cartilage is also a source for slippery synovial fluid. Just like the cartilage, synovial fluids grease up the bones to allow smooth motion as well as to absorb any sudden impacts. When the knee joints function healthily, movements are smooth and without any pain.

But joints can malfunction due to prolonged usage and general wear and tear. In fact, excess body weight puts tremendous pressure on these joints. As time goes by, the durable cartilage reaches its breaking point and simply breaks apart. Synovial fluid gets exhausted as well and the bones start to grind sorely against each other. What starts as mild pain and stiffness can actually progress into excruciating swelling, inflammation and inability to even move said joints. Patients usually start with analgesics therapies and even topical creams. Other popular therapies include consuming supplements, making lifestyle changes, and trying physical therapy.

Hyalgan has been designed as a quick-relief orthopaedic filler that may be used concomitantly with or even instead of these therapies. Sodium hyaluronate gel acts the same way as synovial fluid would when lubricating and protecting the joints from shocks. After administering the filler, the bones no longer rub against each other and painful symptoms of osteoarthritis are lessened.

This orthopaedic injectable filler is of animal origin made from rooster comb. Hence, the appropriateness of this medical device must be determined before starting procedure. In addition, patients’ medical histories (e.g. other existing medical conditions, supplements and medications taken) must be reviewed to reduce the risk of undesirable effects. Thoroughly clean and disinfect the joint. Do not use quaternary ammonium salt containing disinfectants because hyaluronic acid can precipitate in their presence. Remove any fluid buildup and discard the syringe afterwards. Remove the preloaded syringe from the original packaging and attach an appropriately-sized needle to it. You may inject a local anaesthetic, like lidocaine, into the affected joint subcutaneously to reduce pain during the injection process. Inject the entire contents of the 2mL syringe via intra-articular injection into the synovial space of 1 knee joint. Use a second syringe if you are treating both knee joints at the same time.

Discard any unused gel and other used syringes and needles. Advise patients to avoid any prolonged (i.e. more than an hour) strenuous activities (e.g. tennis, weight lifting, jogging) for at least 2 days.

All of the above steps are to be conducted aseptically and only by certified physicians. A complete procedure involves 5 Hyalgan injections given at weekly intervals. Do not inject filler gel into blood vessels as it can result in blood clots, occluded blood flow and even stroke. Refer to the package insert for a complete list of precautions and instructions.

Usually, patients may notice pain relief within a week after treatment, but for the best outcome, a total of 5 injections should be administered every week for 5 weeks. A total of 5 Hyalgan injections can provide improvements for up to 6 months or more. But, these results vary according to the patient’s health status and the severity of osteoarthritis.

Hyalgan is a safe orthopaedic injection made from high-grade materials. In addition, Hyalgan has been researched extensively in various clinical trials to ensure its good safety profile. That being said, some patients should avoid this product due to unestablished safety levels, including:

1. Pregnant people;
2. People who are nursing;
3. Paediatric patients;
4. Patients who are allergic to avian proteins (e.g. poultries, eggs, feathers);
5. Patients who are hypersensitive to hyaluronic acid products;
6. Patients with skin inflammations/infections/disorders on the intended treatment area.

Refer to the package insert for a complete list of contraindications.

Patients may experience some unwanted reactions following Hyalgan injections.

• Pain and tenderness at the injection site
• Gastrointestinal distress
• Bruising
• Rash
• Itching

• Severe headache
• Fever

Patients should seek medical attention if the common symptoms persist or worsen. Refer to the package insert for a complete list of adverse effects.

Hyalgan is a sodium hyaluronate filler gel made using rooster comb. After extraction and purification, the sterile and non-pyogenic gel is reconstituted in a buffer solution of pH 6.8 to 7.5. Once injected, Hyalgan mimics the function of synovial fluid resulting in improvements of osteoarthritis symptoms.

Warning! The product is intended solely for professional use in a medical environment and under professional supervision. The product is supplied to medical professionals who specialize in aesthetic medicine (plastic surgery, facial treatments) and work under individual medical licenses as aestheticians or in dedicated clinics. Unprofessional use by individuals without a medical background may lead to severe adverse effects and health harm.