MONOVISC®

Monovisc Injection Uses

Monovisc is primarily used in the management of knee osteoarthritis. However, it has broader applications in joint health and rehabilitation:

• Treatment of osteoarthritis-related knee pain.
• Lubrication and cushioning of affected joints.
• Reduction of joint stiffness and inflammation.
• Restoration of joint mobility for improved movement.
• Alternative treatment for patients who cannot take NSAIDs.
• Post-surgical recovery support for joint conditions.

Manufacturing Information for Monovisc Injections

Monovisc injection products are developed by a leading biotechnology company Anika Therapeutics specialising in HA-based treatments. The company is based in Bedford, Massachusetts, USA.

Expected Benefits and Results of the Treatments

Monovisc provides multiple advantages for both patients and practitioners:

• Long-lasting pain relief: Eases discomfort for up to six months.
• Single-injection convenience: No need for multiple visits.
• Improved joint mobility: Enhances movement and flexibility.
• Non-surgical alternative: Avoids the risks of surgery.
• High patient satisfaction: Positive reviews and clinical success.

Monovisc Injections Key Ingredients and Device Properties

Monovisc is formulated with carefully selected ingredients to ensure optimal joint lubrication and relief.

Key ingredients:

• Cross-linked sodium hyaluronate (22 mg/ml): Provides viscoelastic properties for joint cushioning.
• Sodium chloride (36 mg): Maintains isotonic balance.
• Potassium chloride (0.8 mg): Supports joint function.
• Potassium phosphate, monobasic (0.8 mg USP): Aids in pH stability.
• Sodium phosphate, dibasic (4.6 mg): Helps buffer the solution.
• Water for injection: Ensures sterility and biocompatibility.

Device properties:

• Single-use, pre-filled sterile syringe.
• High molecular weight HA for prolonged effect.
• Non-animal derived and highly purified.

Included Items or Accessories

Each Monovisc package includes:

• 1 pre-filled syringe: Contains 4 ml (88 mg) of cross-linked HA.
• Sterile packaging: Ensures contamination-free application.
• Instructions for use: Includes product details and administration guidelines.

Administration Method for Monovisc Injections

Monovisc products should always be administered by certified professionals following the appropriate procedures.

Pre-procedure:

• Patient evaluation: Confirm osteoarthritis diagnosis and rule out contraindications.
• Informed consent: Explain risks and benefits to the patient.
• Sterilisation: Clean the injection site with antiseptic.
• Local anaesthesia: Optional for patient comfort.

During procedure:

• Aspiration (if necessary): Remove excess joint fluid.
• Injection: Administer Monovisc into the joint space using a sterile needle.
• Imaging guidance: Optional for accuracy in complex cases.

Post-procedure:

• Compression: Apply a light bandage if needed.
• Observation: Monitor for immediate adverse reactions.
• Activity restrictions: Advise against strenuous exercise for 48 hours.

Guidelines for Proper Aftercare

To ensure the best results and minimise complications, patients should follow these aftercare guidelines after receiving Monovisc injections:

• Avoid strenuous activity for 48 hours: High-impact exercises, heavy lifting, and excessive joint movement should be avoided to allow the injection to settle properly.
• Apply ice packs if swelling occurs: Use a clean ice pack wrapped in a cloth for 10-15 minutes at a time to reduce swelling and discomfort.
• Do not apply heat to the injection site: Avoid hot baths, saunas, and heating pads for at least 48 hours, as heat may increase swelling.
• Refrain from excessive standing or walking: Minimise weight-bearing activities for the first 24-48 hours to reduce stress on the treated joint.
• Stay hydrated: Drink plenty of water to support joint health and overall recovery.
• Avoid anti-inflammatory medications unless advised: NSAIDs such as ibuprofen or aspirin may interfere with the injection’s effects. Consult your doctor before taking them.
• Watch for signs of infection: Redness, warmth, or excessive swelling at the injection site should be monitored. Seek medical attention if symptoms worsen.
• Avoid alcohol for 24 hours: Alcohol can contribute to inflammation and may affect recovery.
• Use supportive footwear if the knee is treated: Wearing cushioned, comfortable shoes can help reduce joint impact while walking.
• Do not massage the treated area: Avoid putting pressure on the injection site to prevent displacement of the injected substance.
• Follow up with your healthcare provider: Schedule any necessary follow-up visits to assess treatment response and discuss future injections if needed.
• Gradually return to normal activity: Light movements and low-impact exercises like swimming or stretching can be introduced after 48-72 hours, as advised by a doctor.
• Report any unusual symptoms: If severe pain, persistent swelling, fever, or joint instability occurs, seek medical advice immediately.

Duration of Monovisc 88 mg/4 ml Effects

Monovisc provides relief for up to six months. Patients may need repeat treatments with orthopedic injections every 6-12 months based on symptom severity.

Monovisc Injection Side Effects

Monovisc is generally well-tolerated, but like any medical treatment, it may cause side effects. Patients should be monitored for any adverse reactions after administration.

Common side effects:

• Mild pain at injection site: Temporary discomfort may occur after the injection.
• Temporary swelling and redness: Inflammation at the injection site is common and usually subsides within a few days.
• Stiffness in the treated joint: Some patients may experience a feeling of tightness or restricted movement initially.
• Warmth at the injection site: A mild warming sensation can occur due to increased blood flow.
• Bruising: Minor bruising may develop, especially in patients prone to bruising.

Less common side effects:

• Joint effusion (fluid accumulation): Some patients may experience increased joint fluid, leading to temporary swelling.
• Limited range of motion: Temporary restriction in movement may occur after injection.
• Fatigue or general discomfort: Some individuals may feel mildly unwell after treatment.

Rare side effects:

• Severe allergic reactions: Signs include swelling of the face, throat, or difficulty breathing. Immediate medical attention is required.
• Infection at the injection site: Although rare, improper injection technique or contamination may lead to infection.
• Joint inflammation or synovitis: Some patients may develop inflammation of the joint lining, causing pain and swelling.
• Severe pain or prolonged swelling: Persistent discomfort lasting beyond a few days may require medical evaluation.
• Skin rash or itching: Hypersensitivity reactions may cause rashes or itchiness at or around the injection site.
• Headaches or dizziness: Some patients report mild headaches or dizziness post-injection.
• Nausea or gastrointestinal discomfort: Though uncommon, some individuals may experience nausea or an upset stomach.
• Fever or flu-like symptoms: A rare systemic reaction where patients may experience fever, chills, or body aches.

Monovisc Injections Treatment Contraindications

Monovisc should not be used in patients with:

• Known allergies to hyaluronic acid: Patients with hypersensitivity to hyaluronic acid or any of the injection components should avoid use.
• Active joint infections: The injection should not be administered if there is an existing infection in or around the treatment area.
• Severe inflammatory conditions: Patients with active inflammatory arthritis, such as rheumatoid arthritis, should consult a specialist before considering Monovisc.
• Systemic infections: Patients with ongoing infections, such as sepsis or viral illnesses, should not receive the injection until fully recovered.
• Bleeding disorders or anticoagulant therapy: Those with haemophilia or who are taking blood thinners may have an increased risk of bleeding at the injection site.
• Previous adverse reactions to intra-articular injections: Patients with a history of severe reactions to joint injections should avoid Monovisc.
• Pregnancy and breastfeeding: The safety of Monovisc during pregnancy or lactation has not been established, and it should only be used if absolutely necessary.
• Paediatric patients: Monovisc is not approved for individuals under 18 years old due to a lack of clinical data on its safety and effectiveness in this age group.
• Severe osteoarthritis with joint deformity: In cases where the cartilage is significantly eroded or joint replacement is imminent, Monovisc may not provide adequate relief.
• Recent corticosteroid injections in the same joint: A waiting period is recommended if corticosteroids were recently administered to avoid interactions or complications.
• Patients with compromised immune systems: Those undergoing immunosuppressive therapy or with autoimmune conditions should consult a healthcare provider before treatment.