Orthovisc Injections (Hyaluronan) – polysaccharide identical to human. Used in rheumatology at arthrosis of major joints and Ophthalmology (healon) for eye operations.
A new highly effective for the treatment of osteoarthritis and osteoarthritis.
• revolution in the treatment of osteoarthritis;
• A new life the old joints;
• eliminates the pain;
• improves joint mobility;
• protect the articular cartilage;
• stimulates the synthesis of hyaluronan own;
• durable therapeutic effect.
Osteoarthritis and osteoarthritis – a degenerative disease of the joints, causing pain and loss of mobility. This is not a passive phenomenon of “wear and tear, it was thought until recently, and the active disease with underlying complex diseases.
Earlier treatment of osteoarthritis and osteoarthritis was limited to symptomatic (aimed at reducing the external manifestations of the disease, in fact, already the consequences of the pathological process), and virtually no regard to the impact on the causes of the disease. Most frequently used non-steroidal anti-inflammatory drugs and the ineffectiveness of recent corticosteroid hormones. However, these drugs are not always effective, many are contraindicated and have lots of complications, in addition, many of them that do not stop, but rather, even intensify the destruction of articular cartilage. Widely used physical therapy, although it has some positive effect, but can not be regarded as quite adequate for this pathology.
Thus, virtually all treatment earlier is to limit physical exertion, wearing various types of elastic bandages, which most often leads to further progression of the disease, the need for patient use a cane, crutches.
Violations of hyaluronic acid homeostasis in the pathogenesis of osteoarthritis and osteoarthritis:
Synovial fluid was detected in all synovial joints, particularly in heavy load-bearing joints, where it provides a normal pain-free movement because of its lubricating and cushioning properties.
Hyaluronic acid is a natural polymer that provides the viscoelastic properties of synovial fluid. In a normal joint, it has a high concentration in the surface layer of articular cartilage, as well as the surface layers of the synovial membrane. In synovial fluid hyaluronic acid acts as a lubricant and shock absorber, located between energonakaplivayuschy agent against each other cartilages, semipermeable barrier that regulates the metabolic exchanges between the cartilage and synovial fluid, the agent that manages the movement of cells and viscoelastic screen around sinoviotsitov and adjacent nerve endings, it also responsible for nutrition of cartilage.
Healthy synovial joint is in a state of equilibrium or homeostasis. Hyaluronic acid is constantly moving in a joint cavity, but its concentration and the profile of the molecular weight remains constant.
In the case of disorders associated with joint damage, such as osteoarthritis and osteoarthritis, hyaluronic acid is depolymerized in the space of joint and split. Homeostasis is disturbed. Synovial fluid becomes less viscous and lubricating, shock-absorbing and filtering capabilities are reduced.
The cover layer of hyaluronic acid on the surface of the joint is destroyed, leaving the cartilage and synovial membrane vulnerable to mechanical and inflammatory lesions.
Synovium becomes inflamed and permeable to inflammatory molecules, which because of it can penetrate into the joint in large quantities.
This leads to increased mechanical stress on joints and cartilage destruction, which ultimately leads to pain and limited mobility of the damaged joint.
Adding with intraarticular injections of highly purified hyaluronic acid can improve the viscoelastic properties of synovial fluid. This increases the lubricating and shock absorbing function and reduces mechanical stress on the joint. Typically, this leads to a decrease in pain and increase joint mobility, which can last for at least several months after the treatment cycle, including five of intraarticular injection.
Active-active substance:
Hyaluronic acid / sodium hyaluronate / Gilan / hyaluronan / Sodium hyaluronate.
Orthovisc Injections (Hyaluronan) Properties / Action:
Sodium hyaluronate (Gilan, a biological analogue of hyaluronan) – is a polysaccharide composed of repeating disaccharide units N-atsetilglikozamina glyukuronata and sodium. Has a high molecular weight. 1% solution of sodium hyaluronate is a hydrated gel.
Orthovisc Injections (Hyaluronan) for intra-articular injection:
Orthovisc Injections (Hyaluronan) is used as a sterile viscoelastic implant for intra-articular injection in the synovial space in patients with mild or moderate osteoarthritis or osteoarthrosis. It is used for the treatment of knee or any other synovial joints.
In fact, is an analogue of human synovial fluid. On this basis, the introduction of Orthovisc Injections (Hyaluronan) in the affected joint breaks a key part of development of osteoarthritis, there is an influence is the cause of the progression of osteoarthritis.
Therapeutic effect Orthovisc Injections (Hyaluronan) is associated with the completion of the viscosity, whereby the improved rheological and physiological status of tissues of the affected joint. In addition, the effect Orthovisc Injections (Hyaluronan) is based on the effect of “trigger mechanism” – the ability to directly restore the joint to produce endogenous hyaluronan and thus returns to a state of homeostasis, which persists for several months.
As shown by the accumulated clinical materials, the application of Orthovisc Injections (Hyaluronan), the following points:
• restores synovial equilibrium: it increases the viscosity of synovial fluid its lubricating restoring, shock absorb and filtration properties;
• protects articular cartilage from mechanical and chemical damage: restores protective coating on the inner surface of the joint and increases the binding of free radicals;
• inflammation of the synovial membrane and decreases its protective function be restored.
Slowing the destruction of articular cartilage in conjunction with the processes of restoration of homeostasis of synovial fluid lead to a rapid withdrawal of pain symptoms and regression phenomena limited mobility in the joint.
Beneficial effect Orthovisc Injections (Hyaluronan) appears gradually during the course and persist for several months. After passing through the full course of 5 injections symptoms are usually removed for a period of 6 to 12 months.
Indications:
For intra-articular injection:
• for pain and limited mobility due to degenerative-dystrophic and traumatic changes of the knee, hip and other synovial joints;
• for the temporary replacement and replenishment of synovial fluid;
• in the treatment of patients with active lifestyle and regularly load on the affected joint.
For intraocular injections (eye surgery):
• Expansion of the anterior chamber or division of tissue, etc. (with operations in the anterior and posterior segments of the eye);
• examination of the retina during and after surgery;
• Conduct laser therapy (adjuvant).
Contraindications:
General:
• Individual intolerance (including history of hypersensitivity) Hyaluronan
For intra-articular injection:
• Presence of infected wounds, sores in the joint;
• infected or severely inflamed joints;
• venous or lymphatic stasis in the side of the affected joint.
Not recommended introduction to cupping events synovitis in mind the dilution of the preparation of synovial fluid and possible reduction in therapeutic effect.
Orthovisc Injections (Hyaluronan) is not recommended for use by pregnant women and nursing mothers, as well as patients suffering from inflammatory diseases such as rheumatoid arthritis and Bechterew’s disease.
Orthovisc Injections (Hyaluronan) Side effects:
For intra-articular injection:
Orthovisc Injections (Hyaluronan) is characterized by excellent tolerance. In clinical studies showed a complete absence of toxic and mutagenic reactions. Due to the shape registration – syringe pen – minimizes the possibility of entry of a secondary infection at the injection.
Possible side effects (usually completely disappear within a few days):
• Local secondary phenomena, such as pain, feeling of warmth, redness and swelling may occur at the joint, which introduced the drug (applying ice to the joint for five – ten minutes will remove all such events);
• the emergence of intra-articular exudation (in some cases, exudation may be significant and cause more prolonged pain) in these cases it is necessary to produce a puncture of the joint and removing fluid from it followed by microscopy to exclude infection and microcrystalline arthropathy (gout);
• extremely rare – allergic reactions.
Special warnings and precautions:
For intra-articular injection:
Some of the drugs Orthovisc Injections (Hyaluronan) contain small amounts of chicken protein, and therefore the treatment of patients with hypersensitivity appropriate caution. Particular attention should be patients suffering from hypersensitivity towards drugs.
Do not enter Orthovisc Injections (Hyaluronan) in the presence of significant intra-articular effusion.
Please follow the general precautions for intra-articular injections. In processing the skin prior to injection can not use disinfectants containing quaternary ammonium salts.
Before the introduction of the solution should be warmed to room temperature.
Orthovisc Injections (Hyaluronan) must be carefully introduced into the joint cavity. You can not enter ekstraartikulyarno, including, in the synovial tissue or joint capsule. In this case, there may be local adverse reactions. Need to avoid getting the drug into the blood vessels!
As well as after any other invasive procedures on the joints, after injection of Orthovisc Injections (Hyaluronan), the patient is recommended to adhere to gentle treatment and avoid unnecessary burdens on the joint for several days.
Do not use the drug if the pre-filled syringe or sterile packaging is damaged.
The effectiveness of treatment, comprising less than three injections, has not been established.
Efficacy and safety of Orthovisc Injections (Hyaluronan) when applying for other indications, except for osteoarthritis or osteoarthritis, has not been established.
Orthovisc Injections (Hyaluronan) is not used for the treatment of pregnant women and children under 18 years old.
During the course of treatment Orthovisc Injections (Hyaluronan) is not allowed entry into the cavity of the affected joint anesthetics or other pharmacologic agents.
Drug Interactions:
For intra-articular injection:
To date, no information concerning the incompatibility of Orthovisc Injections (Hyaluronan) with other solutions for intra-articular use. To facilitate the condition of the patient can take oral analgesics or anti-inflammatory drugs during the first few days of treatments.
