Synvisc – Frequently Asked Questions
1. What is Synvisc?
Synvisc is a milestone viscosupplementation treatment used to relieve pain due to osteoarthritis of the knee. This elastoviscous supplement, injected directly into the knee joint, acts as a shock absorber and lubricant, and is used for patients who do not obtain adequate relief from simple painkillers or from exercise and physical therapy. Synvisc is a device, not a drug, and is designed to replace the diseased synovial fluid found in osteoarthritic knees.
2. What is Synvisc made from?
Synvisc is an elastic and viscous fluid that is made up of hylan A and hylan B. Hyaluronan is a natural chemical found in the body and is present in all tissues, but there is a particularly high amount in joint tissues and in the fluid that fills the knee joint. The body's own hyaluronan acts like a shock absorber and lubricant in the joint, and is needed for the joint to operate properly. In painful osteoarthritic knees, there is deterioration of the quality (low elasticity and viscosity) of the hyaluronan in joint fluid and tissues, or there may not be enough hyaluronan.
3. Is Synvisc a drug or a device?
Synvisc is classified as a device because it exerts its effect by a physical action (elastoviscosity), not by a chemical action. Because it is a non-drug, Synvisc should not interfere with any medicine that the patient may take.
4. What is viscosupplementation?
Viscosupplementation is the therapeutic procedure by which the physical properties (elastoviscosity) of diseased synovial fluid are restored and augmented with an elastoviscous fluid like Synvisc. This will result in a decrease of joint pain, thereby helping the joint to become more mobile.
5. How is Synvisc administered?
Synvisc is injected directly into the knee joint three times (Days 1, 8 and 15) over a 15-day period by a qualified physician.
6. Why are three injections required?
Clinical investigations with Synvisc have demonstrated that three injections one week apart provide optimal pain relief and restoration of joint mobility. Completion of the full three-injection treatment course is recommended to achieve the greatest therapeutic benefit.
7. How do I know if Synvisc is right for me?
A doctor is the best person to advise you on any course of treatment, including Synvisc. So to find out if you are a good candidate for Synvisc treatment, the first step is to make an appointment with Dr Cameron or your family doctor
8. Am I too old for Synvisc?
There are no specific precautions or contraindications regarding the use of Synvisc in elderly patients. During clinical trials, the safety profile of Synvisc was well established in elderly patients. This may be attributed to the local, nonpharmacologic action of Synvisc, as well as to its lack of interactions with medications of other concurrent diseases. The mean age of men and women who participated in Synvisc premarketing clinical trials was 61 years (range of 18 to 93), with the majority of patients over 40 years.
9. At what point in the treatment of osteoarthritis should Synvisc be considered?
Synvisc is indicated for the treatment of pain in osteoarthritis of the knee in patients who have failed to respond adequately to physiotherapy and simple painkillers like paracetamol. Dr Cameron will be happy to advise if there is concern.
10. Can I receive Synvisc in both of my knees?
Yes, if both knees have pain. Synvisc treatment may be given in both knees simultaneously or separately, according to your physician's recommendations.
11. Can I take other medications while receiving Synvisc treatment?
Yes. Since Synvisc is an elastoviscous fluid device injected directly into the knee joint, it does not interfere with any medicine that your physician recommends, including pain relievers and anti-inflammatory drugs. You should discuss with your physician any medicine taken.
12. Should I modify my level of physical activity after receiving Synvisc treatment?
Dr Cameron will advise about what level of activity is right for you, but in general, patients are able to maintain their normal daily activities after receiving treatment. However, patients should avoid strenuous activities such as jogging, tennis and heavy lifting for at least 48 hours after receiving an injection.
13. Is Synvisc treatment effective in knees with advanced osteoarthritis and loss of cartilage?
Synvisc has been shown to be effective in all stages of this disease, although it is most effective in the early stages of joint pathology. However, some patients with advanced osteoarthritis have also responded to Synvisc with variable results. All patients receiving Synvisc should be mobile and have no health conditions that prevent normal use of the knee.
14. Can Synvisc be used in joints other than the knee?
The U.S. Food and Drug Administration approved patient information which states: "The safety and effectiveness of Synvisc in locations other than the knee and for conditions other than osteoarthritis have not been established." Some doctors are beginning to gain experience with its use in other joints.
15. Is Synvisc a cure for osteoarthritis of the knee?
There is no cure for osteoarthritis. Synvisc is a treatment for the pain of osteoarthritis. In some patients, successful treatment may reduce pain within the first week after treatment begins. In most patients, the most pain relief and the greatest amount of treatment success occurred 8 to 12 weeks after Synvisc treatment began.
16. What are the benefits of receiving Synvisc treatment?
Successful treatment with Synvisc should reduce pain in an osteoarthritic knee, resulting in increased mobility. In addition, because it is a non-drug, local treatment, Synvisc should not interfere with any medicine that the patient may take.
17. How soon after Synvisc treatment should I experience relief?
Each patient's response to Synvisc regarding relief of pain and restoration of joint mobility will vary, depending upon the stage of joint pathology and pre-existing medical conditions. In general, however, some patients experienced significant pain relief within the first week after Synvisc treatment began. In most patients, the most pain relief and the greatest amount of treatment success occurred 8 to 12 weeks after treatment began.
18. How long can I expect the benefits of Synvisc to last?
Each patient reacts differently to Synvisc treatment. The benefits of Synvisc can last for months, but in most patients, the most pain relief and the greatest amount of treatment success occurred 8 to 12 weeks after treatment began. There are several clinical studies that address the effectiveness of Synvisc treatment.
19. How safe is Synvisc?
Extensive safety and toxicity tests were performed on Synvisc before the first clinical trials. Synvisc has been safely used in ophthalmic and orthopaedic applications in millions of patients. In clinical trials, transient local pain or swelling occurred in 2.2% of intra-articular injections of Synvisc.
20. What are the side effects of Synvisc?
There have been no general (systemic) side effects attributed to Synvisc. However, because Synvisc is injected directly into the joint, some patients may feel localised discomfort after treatment. Some pain, swelling and effusion may occur in and around the knee. Both usually go away within a short period and do not interfere with the success of the treatment. If you continue to feel discomfort or notice other problems, you should consult your physician.
21. Are there any allergies that may affect Synvisc treatment?
No cases of anaphylaxis or allergic reactions have been reported in connection with Synvisc treatment. You should ask Doctor Cameron if you have a history of hypersensitivities to hyaluronan preparations or are allergic to bird proteins, feathers and egg products.
The Cameron Medical Website has a huge amount of content on issues related to joint pain, arthritis, back pain and other orthopaedic or joint problems. Most of it is written by Dr Cameron specially for this website. Click here to see what's available.