Table of ContentsView AllTable of ContentsHow Injections HelpEuflexxaSynviscComparisonsOther InjectionsSide Effects & WarningsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
How Injections Help
Euflexxa
Synvisc
Comparisons
Other Injections
Side Effects & Warnings
Frequently Asked Questions
Knee osteoarthritis is a chronic degenerative joint disease that can cause pain, swelling, stiffness, and loss of motion. If you’ve been diagnosed with osteoarthritis in your knee or knees, there are several treatment options, both surgical and nonsurgical.
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Since knee osteoarthritis is a chronic degenerative disease, your healthcare provider may suggest starting with more conservative treatments before progressing to more aggressive or invasive ones. Your healthcare provider may suggest physical therapy andlow-impact exercisesto improve movement and nonsteroidal anti-inflammatory drugs (NSAIDs) to help with pain and swelling.
Corticosteroid injectionshave also been used to treat osteoarthritis. If these therapies do not improve your symptoms, viscosupplements like Euflexxa and Synvisc may be prescribed to help ease arthritis pain and promote movement.Your healthcare provider may refer to these injections as “viscosupplementation,” which means they help the fluid in your joints.
In some cases,total knee replacementbecomes necessary. However, hyaluronic viscosupplements have been shown to delay the necessity of total knee replacement surgery.
How Hyaluronic Acid Injections Help Arthritis
Hyaluronic acid is naturally found in cartilage and the synovial fluid between the joints. In osteoarthritis, hyaluronic acid decreases, thus causing pain, inflammation, and problems with movement.
There is some debate over the effectiveness of these injections. Some studies have shown that the effects are only marginally different than placebo, but others have shown marked improvement of joint pain and mobility.
The American College of Rheumatology conditionally recommends the use of hyaluronic acid injections in those who have not found relief with other treatments such as NSAIDs or physical therapy.In these cases, patients have experienced pain relief that can last up to six months.
What Is Euflexxa?
What Is Synvisc?
Synvisc is another hyaluronic acid injection used to treat the pain of knee osteoarthritis. There are two versions of Synvisc—Synvisc and Synvisc One. Synvisc One requires only one injection.Synvisc requires three.
Typically, a specialist such as an orthopedic surgeon or rheumatologist will administer the injections for Synvisc over the course of three healthcare provider visits, one week apart. After your injections, you may start to feel relief right away.
However, you need to have all three injections to experience the most benefit. Most people will find that they feel the best eight to 12 weeks after their first injection.
With Synvisc One, most people feel relief after a month. Both treatments can provide pain relief from arthritis for up to six months.
How Euflexxa and Synvisc Are Different
Though Euflexxa and Synvisc are both hyaluronic viscosupplements, there are some differences. Both Euflexxa and Synvisc consist of a three-injection treatment course. However, Synvisc One only requires one injection.
Both treatments are made from sodium hyaluronate and purified, but they use different methods. Euflexxa contains a substance extracted from bacteria cells. Synvisc One uses a substance that comes from chicken combs.
Both Euflexxa and Synvisc are effective at treating the pain and decreased mobility that accompany knee osteoarthritis. When choosing which to use, you may want to talk to your healthcare provider and your insurance company to decide which is best for you.
Sometimes cost can be the deciding factor. You may also want to consider whether you can commit to taking three injections one week apart or if your schedule is better suited for one injection. In that case, treatment with Synvisc One may be your best option.
EuflexxaThree weekly injectionsSodium hyaluronate made from a substance extracted from bacterial cellsTreats osteoarthritis knee pain for up to six monthsSynviscOption of one injection (Synvisc One) or three weekly injectionsSodium hyaluronate made from a substance that comes from chicken combsTreats osteoarthritis knee pain for up to six months
EuflexxaThree weekly injectionsSodium hyaluronate made from a substance extracted from bacterial cellsTreats osteoarthritis knee pain for up to six months
Three weekly injections
Sodium hyaluronate made from a substance extracted from bacterial cells
Treats osteoarthritis knee pain for up to six months
SynviscOption of one injection (Synvisc One) or three weekly injectionsSodium hyaluronate made from a substance that comes from chicken combsTreats osteoarthritis knee pain for up to six months
Option of one injection (Synvisc One) or three weekly injections
Sodium hyaluronate made from a substance that comes from chicken combs
Other Hyaluronic Viscosupplements
Euflexxa vs. Orthovisc vs. Synvisc
Hyaluronic viscosupplements are meant to restore joint fluid back to its original state, so using a medication that is as similar to synovial fluid as possible makes sense.
In a study comparing these and similar drugs, the structure and properties of Euflexxa and Orthovisc were found to be the closest to those of healthy knee joint fluid.
Synvisc also had similar properties, but a different structure.
Side Effects and Warnings
Like all medications, Euflexxa and Synvisc carry the possibility of side effects. It is important to talk to your healthcare provider about any common side effects that do not go away or become severe. The most common side effects with viscosupplements are:
Warnings
If you have had an allergic reaction to any hyaluronan-based products, you should not use these medications. Signs of an allergic reaction include swelling of the face, tongue, or throat, difficulty breathing or swallowing, wheezing, chest pain, hives, sleepiness, and/or fever.
After your injections, it is recommended that you avoid physical activities like running, hiking, biking, and swimming for at least 48 hours. To keep your knee from swelling, it is also recommended that you avoid standing on your feet for more than one hour at a time.
Synvisc and Euflexxa have not been tested in people under the age of 21 or who are pregnant or nursing. Talk to your healthcare provider if you fall into these categories, as these treatments may not be recommended.
When to Call Your Healthcare ProviderMost side effects from Euflexxa and Synvisc will lessen over time. However, if you experience any side effects that worsen or do not go away, talk to your healthcare provider.If you experience any of the following symptoms, seek emergency help immediately:Shortness of breath or trouble breathingSwelling of the face or throatThese may indicate a life-threatening allergic reaction.
When to Call Your Healthcare Provider
Most side effects from Euflexxa and Synvisc will lessen over time. However, if you experience any side effects that worsen or do not go away, talk to your healthcare provider.If you experience any of the following symptoms, seek emergency help immediately:Shortness of breath or trouble breathingSwelling of the face or throatThese may indicate a life-threatening allergic reaction.
Most side effects from Euflexxa and Synvisc will lessen over time. However, if you experience any side effects that worsen or do not go away, talk to your healthcare provider.
If you experience any of the following symptoms, seek emergency help immediately:
These may indicate a life-threatening allergic reaction.
A Word From Verywell
Living with the pain from knee osteoarthritis can be frustrating, especially if it limits your daily activities. Understanding your treatment options and staying proactive in your treatment plan can help you live a full, active life with osteoarthritis.
Frequently Asked QuestionsNo, Euflexxa is made from a substance extracted from bacteria cells. Synvisc, another hyaluronic viscosupplement, is made using chicken combs.Like most treatments, it carries risks of side effects or allergic reactions. It is not safe for anyone with a knee joint infection or a skin disease or infection around the injection site, or anyone with a previous allergic reaction to a sodium hyaluronate product.The injection may be uncomfortable and there may be some temporary pain. Side effects may also include joint pain, back pain, limb pain, muscle pain, or joint swelling.
No, Euflexxa is made from a substance extracted from bacteria cells. Synvisc, another hyaluronic viscosupplement, is made using chicken combs.
Like most treatments, it carries risks of side effects or allergic reactions. It is not safe for anyone with a knee joint infection or a skin disease or infection around the injection site, or anyone with a previous allergic reaction to a sodium hyaluronate product.
The injection may be uncomfortable and there may be some temporary pain. Side effects may also include joint pain, back pain, limb pain, muscle pain, or joint swelling.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kolasinski SL, Neogi T, Hochberg MC, et. al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.2413Webb D, Naidoo P.Viscosupplementation for knee osteoarthritis: a focus on Hylan G-F 20.Orthop Res Rev. 2018;10:73-81. doi:10.2147/ORR.S174649Dasa V, DeKoven M, Sun K, Scott A, Lim S.Clinical and cost outcomes from different hyaluronic acid treatments in patients with knee osteoarthritis: evidence from a US health plan claims database.Drugs Context. 2016;5:212296. doi:10.7573/dic.212296Gupta RC, Lall R, Srivastava A, Sinha A.Hyaluronic acid: molecular mechanisms and therapeutic trajectory.Front Vet Sci. 2019;6:192. doi:10.3389/fvets.2019.00192Euflexxa.com.FAQs: How is EUFLEXXA given?Food and Drug Administration.EUFLEXXA - product information.Sanofi US.SYNVISC ONE® HYLAN G-F 20 prescribing information.Synvisc-One® Official Site.Frequently asked questions.Synvisc-One® Official Site.Frequently asked questions.Bowman S, Awad ME, Hamrick MW, Hunter M, Fulzele S.Recent advances in hyaluronic acid based therapy for osteoarthritis.Clin Transl Med. 2018;7(1):6. doi:10.1186/s40169-017-0180-3Nicholls M, Manjoo A, Shaw P, Niazi F, Rosen J.A comparison between rheological properties of intra-articular hyaluronic acid preparations and reported human synovial fluid.Adv Ther. 2018;35(4):523-530. doi:10.1007/s12325-018-0688-yEuflexxa.com.EUFLEXXA patient brochure.Euflexxa.com.Important safety information.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kolasinski SL, Neogi T, Hochberg MC, et. al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.2413Webb D, Naidoo P.Viscosupplementation for knee osteoarthritis: a focus on Hylan G-F 20.Orthop Res Rev. 2018;10:73-81. doi:10.2147/ORR.S174649Dasa V, DeKoven M, Sun K, Scott A, Lim S.Clinical and cost outcomes from different hyaluronic acid treatments in patients with knee osteoarthritis: evidence from a US health plan claims database.Drugs Context. 2016;5:212296. doi:10.7573/dic.212296Gupta RC, Lall R, Srivastava A, Sinha A.Hyaluronic acid: molecular mechanisms and therapeutic trajectory.Front Vet Sci. 2019;6:192. doi:10.3389/fvets.2019.00192Euflexxa.com.FAQs: How is EUFLEXXA given?Food and Drug Administration.EUFLEXXA - product information.Sanofi US.SYNVISC ONE® HYLAN G-F 20 prescribing information.Synvisc-One® Official Site.Frequently asked questions.Synvisc-One® Official Site.Frequently asked questions.Bowman S, Awad ME, Hamrick MW, Hunter M, Fulzele S.Recent advances in hyaluronic acid based therapy for osteoarthritis.Clin Transl Med. 2018;7(1):6. doi:10.1186/s40169-017-0180-3Nicholls M, Manjoo A, Shaw P, Niazi F, Rosen J.A comparison between rheological properties of intra-articular hyaluronic acid preparations and reported human synovial fluid.Adv Ther. 2018;35(4):523-530. doi:10.1007/s12325-018-0688-yEuflexxa.com.EUFLEXXA patient brochure.Euflexxa.com.Important safety information.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kolasinski SL, Neogi T, Hochberg MC, et. al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.2413Webb D, Naidoo P.Viscosupplementation for knee osteoarthritis: a focus on Hylan G-F 20.Orthop Res Rev. 2018;10:73-81. doi:10.2147/ORR.S174649Dasa V, DeKoven M, Sun K, Scott A, Lim S.Clinical and cost outcomes from different hyaluronic acid treatments in patients with knee osteoarthritis: evidence from a US health plan claims database.Drugs Context. 2016;5:212296. doi:10.7573/dic.212296Gupta RC, Lall R, Srivastava A, Sinha A.Hyaluronic acid: molecular mechanisms and therapeutic trajectory.Front Vet Sci. 2019;6:192. doi:10.3389/fvets.2019.00192Euflexxa.com.FAQs: How is EUFLEXXA given?Food and Drug Administration.EUFLEXXA - product information.Sanofi US.SYNVISC ONE® HYLAN G-F 20 prescribing information.Synvisc-One® Official Site.Frequently asked questions.Synvisc-One® Official Site.Frequently asked questions.Bowman S, Awad ME, Hamrick MW, Hunter M, Fulzele S.Recent advances in hyaluronic acid based therapy for osteoarthritis.Clin Transl Med. 2018;7(1):6. doi:10.1186/s40169-017-0180-3Nicholls M, Manjoo A, Shaw P, Niazi F, Rosen J.A comparison between rheological properties of intra-articular hyaluronic acid preparations and reported human synovial fluid.Adv Ther. 2018;35(4):523-530. doi:10.1007/s12325-018-0688-yEuflexxa.com.EUFLEXXA patient brochure.Euflexxa.com.Important safety information.
Kolasinski SL, Neogi T, Hochberg MC, et. al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.2413
Webb D, Naidoo P.Viscosupplementation for knee osteoarthritis: a focus on Hylan G-F 20.Orthop Res Rev. 2018;10:73-81. doi:10.2147/ORR.S174649
Dasa V, DeKoven M, Sun K, Scott A, Lim S.Clinical and cost outcomes from different hyaluronic acid treatments in patients with knee osteoarthritis: evidence from a US health plan claims database.Drugs Context. 2016;5:212296. doi:10.7573/dic.212296
Gupta RC, Lall R, Srivastava A, Sinha A.Hyaluronic acid: molecular mechanisms and therapeutic trajectory.Front Vet Sci. 2019;6:192. doi:10.3389/fvets.2019.00192
Euflexxa.com.FAQs: How is EUFLEXXA given?
Food and Drug Administration.EUFLEXXA - product information.
Sanofi US.SYNVISC ONE® HYLAN G-F 20 prescribing information.
Synvisc-One® Official Site.Frequently asked questions.
Bowman S, Awad ME, Hamrick MW, Hunter M, Fulzele S.Recent advances in hyaluronic acid based therapy for osteoarthritis.Clin Transl Med. 2018;7(1):6. doi:10.1186/s40169-017-0180-3
Nicholls M, Manjoo A, Shaw P, Niazi F, Rosen J.A comparison between rheological properties of intra-articular hyaluronic acid preparations and reported human synovial fluid.Adv Ther. 2018;35(4):523-530. doi:10.1007/s12325-018-0688-y
Euflexxa.com.EUFLEXXA patient brochure.
Euflexxa.com.Important safety information.
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