Since naturally occurring hyaluronic acid (HA) is quickly degraded and resynthesized by the body, most HA-based therapeutics require stabilization. Other viscosupplementation products contain HA derived from rooster combs, which increases patients’ risk of developing allergic reactions to animal proteins. 8 NATURALLY-SOURCEDĬINGAL is a transparent gel made from a natural substance called sodium hyaluronate, also known as hyaluronan or hyaluronic acid (HA), produced by bacterial fermentation. 9 CINGAL has an optimal high molecular weight HA averaging 1.9 million Daltons. Optimal high molecular weight HA results in greater pain reduction and longer duration of effect than low molecular weight or excessively high molecular weight. It is important that the molecular weight of HA is not too low, but not excessively high. The high molecular weight of HA gives the synovial fluid its essential viscous and lubricating properties. Unlike other steroids with shorter duration, TH lasts in the joint knee for 21 days. CINGAL is formulated with a high concentration of HA with a total delivered dose of 88 mg, intended to mimic the high concentration of HA found in healthy synovial fluid.ĬINGAL combines a high concentration HA formulation with triamcinolone hexacetonide (TH). The viscoelasticity of the synovial fluid is determined by both the concentration and the molecular weight of the HA. HA is a major component of the extracellular matrix and is naturally found in high concentrations in the synovial fluid surrounding joints. 4 CINGAL ® combines a fast acting steroid with Anika’s proprietary cross-linked hyaluronic acid formulation in one single injection treatment to provide rapid pain relief that lasts. 3 In addition, pharmacological management of OA could result in progressive damage of the joint due to the focus on the reduction of stress-induced pain without additional viscous efficacy. Prolonged use of acetaminophen and non-steroidal anti-inflammatories (NSAIDS) can put the patient at risk for significant side effects of liver toxicity (acetaminophen) 2 and severe gastrointestinal complications. Intra-articular HA injections have been used for over 25 years 1 to treat the symptoms of OA with minimal side effects. HA acts as a joint lubricant, providing pain relief and increased mobility. Viscosupplementation is a procedure where hyaluronic acid (HA) is injected into the synovial fluid surrounding the knee joint for the treatment of the pain associated with osteoarthritis. Viscosupplementation represents an effective, safe, convenient, and non-surgical therapeutic alternative or adjunct to physical therapy, medication or surgery.
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