ORTHOVISC®

What is Orthovisc?

Orthovisc is a viscosupplement used to treat osteoarthritis symptoms in various synovial joints. The elastic and high molecular weight gel is sterile, free from pyrogens and is made from sodium hyaluronate with a strength of 15mg/mL. This gel is packaged in a 2mL syringe and is sold together with labels to ensure traceability and package insert. Store this sterilised package in temperature between 2℃ to 25℃ and protect it from freezing temperatures.

What is it used for?

Orthovisc is the perfect choice for osteoarthritic patients who are unable to control joint pain via usual methods like consuming pain relievers, wearing rehabilitation gears, losing weight, and occupational therapy sessions. Patients may use Orthovisc together with these methods or even replace them for better disease management. The implant allows the damaged synovial joints to regain lubrication and strength. So, symptoms like pain and swelling can be greatly reduced.

How does this viscosupplement work?

Synovial joints are highly movable and characterized mainly by the presence of synovial fluid. The hips and knees are prime examples of synovial joints. Bones encapsulated in the joints are actually covered by a thin layer of durable tissue called articular cartilage. Besides providing a smooth surface for the bones to glide on, the cartilage also secretes synovial fluid continuously into the space between the bones. The slippery fluid further lubricates the joints for pain-free flexible movements as well as to absorb shocks to preserve joint integrity.

However, factors like ageing, excessive body weight, family history and old injuries alter joint health and structure for the worse. The once-durable articular cartilage becomes damaged and breakable causing a decline in synovial fluid production. As a result, joints ravaged by osteoarthritis are rather painful and stiff to move. The condition is exacerbated when small bone fragments grow on the unprotected bone surface, causing more pain and inflammations. The final stage of osteoarthritis is marked by an inability to move said joints as well as the need for corrective procedures.

Orthovisc is created to retain the remaining joint physiology and function. The gel envelopes the bones protectively from painful frictions during motion and cushions the joints from impacts. Hence, patients can resume their usual activities comfortably with minimal pain. Surgeries can also be delayed until absolutely needed.

How to inject it?

This orthopaedic implant is indicated to be injected into the synovial space of affected joints. The step-by-step guide is provided below:

Before procedure:

• Ensure the sterile packaging is still intact and within its shelf life.
• Leave it at room temperature 20 to 45 minutes before use.
• Remove any fluid buildup in the joint, if present. Discard this needle.
• Prepare the area for injections by sanitising, and applying a local anaesthetic, if required.

During procedure:

• Carefully remove the syringe from its packaging and remove the rubber cap.
• Attach a needle (18G to 21G) to the syringe.
• Inject the implant gel intra-articularly into the joint space slowly. Do not overfill. 

After procedure:

• Dispose any leftover gel and used needles appropriately.
• Patients are recommended to be given a total of 3 to 4 injections, 1 week apart. The amount of implant gel varies according to the injury site. Small synovial joints (e.g. thumb) need only 1mL of gel whereas larger joints (e.g. knees, hips) require not more than 2mL of implant gel. That being said, do not resterilise used syringe which still contains any leftover gel. Only legally certified doctors specialising in orthopaedic injections should perform this procedure. Observe strict aseptic techniques throughout the session. Refer to patient information leaflet for more information on directions for use and safety precautions.

How long does the injection last?

Orthovisc can provide up to 6 months of pain-free joint movements. The sodium hyaluronate gel is bioresorbable and will be disintegrated into the surrounding tissues. Patients can choose to get more injections after the initial effects wear off. The results vary across individuals.

Is this product safe?

Orthovisc is an exceptionally safe product as it is manufactured biotechnologically via bacterial fermentation. In addition, sodium hyaluronate is a major constituent of synovial fluid. Hence, this gel impose very little risk of foreign body reactions. Patients who are allergic to avian proteins can safely use this hyaluronate based gel. However, some of your patients might be contraindicated from using this viscosupplement, including:

1. Patients with hypersensitivity to hyaluronic acid;
2. Patients with hypersensitivity to gram positive bacteria proteins;
3. Patients with skin infections/inflammation/diseases present near the affected joints;
4. Patients with bleeding disorders.

The safety profile of Orthovisc is still unestablished in expecting mothers, lactating women, and kids. Refer to patient information leaflet for more contraindications.

Orthovisc side effects

Since the gel is made of highly-purified materials, the side effects that patients may experience are caused by the injection process itself and are harmless.

Common side effects:

• Transient pain at the injection site
• Transient swelling at the injection site

Those reactions are very mild.

Rare reactions:

• Infection

They should seek emergency care if the symptoms persist or worsen. Refer to patient information leaflet for more information on possible side effects.

What is it made of?

Orthovisc is a non-animal orthopaedic gel with sodium hyaluronate base. It is derived from bacterial fermentation of gram positive bacteria cultures which are further processed to produce an elastic, tissue-friendly and bioresorbable gel. After administering, the gel improves joint movement and stability.