Arthritis Osteoarthritis Treatment Orthovisc Treatment for Knee Joints By Carol Eustice Carol Eustice Facebook Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. Learn about our editorial process Updated on August 23, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Marissa Sansone, MD Medically reviewed by Marissa Sansone, MD LinkedIn Marissa Sansone, MD, is a board-certified doctor of internal medicine and a current fellow in rheumatology at Yale University. She actively teaches rheumatology to medical residents and students, and peer-reviews abstracts in the journal Rheumatology. Learn about our Medical Expert Board Print Orthovisc is a viscous (thick) solution of high molecular weight, highly purified sodium hyaluronate in physiological saline. Hyaluronan, which is found in the human body, lubricates the joints and acts as a shock absorber. With osteoarthritis, natural hyaluronan is compromised. Orthovisc is one of the hyaluronates used in a procedure known as viscosupplementation. Orthovisc is a non-animal sourced viscosupplement that is injected directly into the knee joint to restore the cushioning and lubricating properties of the normal joint fluid (i.e., synovial fluid). GARO/PHANIE/Getty Images Indications Orthovisc was approved by the Food and Drug Administration (FDA) on February 4, 2004, for the treatment of pain associated with knee osteoarthritis in patients who failed to achieve adequate relief with more conservative treatment (e.g., exercise, physical therapy) and the use of simple analgesics, such as acetaminophen. Orthovisc is considered a medical device, not a drug, as is the case with other hyaluronates used in viscosupplementation. Orthovisc is administered as a series of three or four weekly intra-articular injections. According to the manufacturer of Orthovisc, it can produce beneficial effects that last up to 26 weeks. Contraindications People with a known hypersensitivity to hyaluronan products should not be treated with Orthovisc or any of the viscosupplements. Also, people with a known allergy to birds or bird products should not use Orthovisc. (Note: This warning is applied to all hyaluronan products.) People with an infection in the knee joint, other infection, or skin disease in the area where the injection would be given should not be treated with Orthovisc. Common Side Effects and Adverse Events The most common adverse events associated with Orthovisc treatment during clinical studies included arthralgia, back pain, and headache. Other adverse events were local injection site reactions Precautions and Warnings As with any intra-articular injection, it is recommended that the patient avoid strenuous activities or prolonged weight-bearing activities for 48 hours. Also, it should be noted that pain or swelling may occur after the injection, but normally it will diminish after a short time period. Also noteworthy, the safety and effectiveness of Orthovisc have not been established in pregnant women, lactating women, or children. The Bottom Line Other FDA-approved viscosupplements, along with the date they were approved, include: Hyalgan 05/28/1997 Synvisc 08/08/1997 Supartz 01/24/2001 Euflexxa 12/03/2004 According to the American Association of Orthopaedic Surgeons (AAOS) the most recent research has not found viscosupplementation to be effective at significantly reducing pain or improving function, although some patients report pain relief. It has been suggested that viscosupplementation has the best chance of being effective when arthritis is in its early stages (i.e., mild to moderate knee osteoarthritis). Even so, the American College of Rheumatology and the Arthritis Foundation conditionally recommend against intra-articular hyaluronic acid injections for knee arthritis. Was this page helpful? Thanks for your feedback! Learn tips for managing arthrits pain, medications, and daily challenges. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Goldberg VM, Goldberg L. Intra-articular hyaluronans: the treatment of knee pain in osteoarthritis. J Pain Res. 2010;3:51–56. Published 2010 May 10. doi:10.2147/jpr.s4733 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. Published 2016 Jun 23. doi:10.7573/dic.212296 Ma B-J, Shanmugham S. Acute ischemic stroke associated with orthoVisc (hyaluronic acid) injection. Journal of Medical Cases. 2017;8(7):219-223. doi:10.14740/jmc2853w American. Academy of Orthopedic Surgeons. Viscosupplementation Treatment for Knee Arthritis. 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 & Research. Feb 2020;72(2):149-162. doi:10.10002/acr.24131 Additional Reading Anika Therapeutics. Orthovisc. FDA. Orthovisc Patient Information. Food and Drug Administration (FDA). Orthovisc High Molecular Weight Hyaluronan.