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Comparing Hyalgan and Other Hyaluronic Acid Injections for Osteoarthritis Treatment: Efficacy and Safety Analysis

Post written by admin on November 16, 2023

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Margaret is a senior adult who found herself facing the challenges of osteoarthritis. Her passion for gardening, which had once brought her so much joy, has recently become a painful task due to the stiffness and discomfort in her knees. Upon her doctor’s recommendation, Margaret decided to try a non-surgical solution – hyaluronic acid injections – fingers crossed to get her mobility back. 

After several weeks, Margaret noticed a significant improvement. The pain in her knees gradually subsided, and she found it easier to move and bend. Margaret was thrilled to restore her mobility and perform daily tasks with increased ease. “Hyalgan had significantly transformed my experience and relieved me from the discomfort that came with osteoarthritis. I am leading a better life now,” says Margaret.

Besides Hyalgan, there are other hyaluronic acid injection products available in the market, such as Synvisc, Euflexxa, Monovisc, and Orthovisc. In the following sections, we will examine the details of hyaluronic acid injections, offering a comprehensive comparison of their effectiveness and safety considerations.

An In-Depth Analysis of Hyalgan

What is Hyalgan?

Hyalgan is a hyaluronic acid-based product designed for the treatment of osteoarthritis. Hyaluronic acid, present in the synovial fluid of joints, serves as both a lubricant and a shock absorber, and it occurs naturally. In the case of osteoarthritis, this fluid can become thinner and less effective, leading to pain and joint stiffness. Hyalgan is a synthetic version of hyaluronic acid and supplements the natural fluid in the joint.

Healthcare professionals typically administer Hyalgan through a simple in-office procedure. A healthcare professional, often a rheumatologist or orthopedic specialist, will clean the injection site and use a fine needle to inject Hyalgan into the affected joint. The process is efficient, allowing patients to return to their daily activities following the injection quickly.

Efficacy and Safety

A study examined the safety and effectiveness of intra-articular sodium hyaluronate, specifically Hyalgan, in the treatment of ankle osteoarthritis (OA). Thirty patients with confirmed ankle OA were randomly assigned to receive either sodium hyaluronate or a control treatment. The primary measure of success was analyzing the pain during movement and weight-bearing, using the Ankle Osteoarthritis Scale (AOS) after three months.

The results showed that the group receiving sodium hyaluronate demonstrated a significant improvement in AOS scores compared to the control group after three months. Notably, both groups exhibited a low incidence of adverse events, and post-injection flares were absent. This study suggests that sodium hyaluronate might be a safe and practical choice for alleviating pain linked to ankle OA. Nevertheless, further comprehensive studies are necessary to validate these findings.

Hyalgan has a well-established safety profile. Typically, side effects are mild and temporary, often manifesting as brief discomfort or swelling at the injection site. Severe or long-lasting side effects are rare. Hyalgan is safe for most patients, but it may not be suitable for individuals with specific allergies or some underlying medical conditions. Before administering the treatment, healthcare professionals conduct a thorough evaluation of the patient’s profile to guarantee their safety and suitability for each person.

Comparative Analysis of Other Hyaluronic Injections

In our quest to provide a comprehensive understanding of hyaluronic acid injections for osteoarthritis treatment, it’s essential to define and distinguish some of the notable alternatives to Hyalgan. These alternatives include Synvisc, Euflexxa, Monovisc, and Orthovisc, each with its unique characteristics and applications.


  • Synvisc: To provide long-lasting relief, healthcare professionals administer Synvisc as a series of injections to alleviate osteoarthritis symptoms in the knee joint. It acts as a lubricant and cushion within the knee joint, minimizing pain and improving joint function.
  • Euflexxa: Euflexxa, primarily used for knee osteoarthritis, provides pain relief and enhances joint mobility. With a series of injections, Euflexxa offers a unique formulation as an alternative to Hyalgan.
  • Monovisc: Offering a convenient and effective option for patients with knee osteoarthritis, Monovisc is a single-injection hyaluronic acid treatment. It reduces pain and improves joint function, providing a viable alternative to multiple injections.
  • Orthovisc: Administered in a series of injections to supplement natural synovial fluid, Orthovisc is another hyaluronic acid injection for knee osteoarthritis. It reduces pain and increases joint flexibility, offering an additional choice for patients seeking osteoarthritis relief.


  • Synvisc: Several studies have compared the effectiveness of Synvisc with various treatments, such as saline injections, steroids, anti-inflammatory drugs, and standard care. Notably, two well-designed randomized, placebo-controlled trials have provided strong evidence supporting the highly effective pain reduction of Synvisc in weight-bearing and activity-related pain at both the 12 and 26-week post-treatment periods.

Furthermore, a multicenter trial with blinded evaluators demonstrated that the pain relief from Synvisc persists longer compared to steroid injections, with significant overall improvement reported at the 26-week mark. Additionally, two other multicenter trials evaluated Synvisc in comparison to the continuous use of anti-inflammatory drugs, with one suggesting equal effectiveness and the other indicating that Synvisc may offer superior pain relief.

  • Euflexxa: The FLEXX trial has demonstrated the efficacy of Euflexxa (IA-BioHA) in the treatment of knee osteoarthritis. This meticulously designed study featured randomized and double-anonymized comparisons, pitting Euflexxa against a saline control group. The outcomes were striking, revealing that Euflexxa delivered substantial pain relief and enhanced joint function over 26 weeks. Patients who received Euflexxa reported a median pain reduction of 53%, while those in the control group experienced a 38% reduction.
  • Monovisc: According to a European study, Monovisc demonstrated both safety and effectiveness, with more than 90% of patients reporting pain improvement and nearly half of them achieving a substantial 40% or more significant clinical enhancement in their total WOMAC score within six months. A pivotal study in the United States and Canada, evaluated by the FDA, showed Monovisc’s potential, resulting in significant pain and clinical improvements compared to baseline. With its single-injection approach, safety record, and clinical benefits, Monovisc offers a promising solution for managing knee osteoarthritis pain, providing hope to those seeking accessible and effective treatment.
  • Orthovisc: Clinical trials assessing Orthovisc have demonstrated notable pain reductions in knee osteoarthritis patients. Significantly more individuals receiving Orthovisc experienced a 40% and 50% reduction in their baseline pain compared to those in the placebo groups. It highlights the substantial pain relief Orthovisc offers, mainly when administered in a four-weekly injection regimen. Furthermore, these clinical studies revealed that Orthovisc’s positive effects endured over time, with patients reporting substantial improvements from weeks 7 through 22. That suggests that Orthovisc can provide enduring relief for individuals with knee osteoarthritis, ultimately enhancing their overall quality of life.


Safety profiles of Synvisc, Euflexxa, Monovisc, and Orthovisc are well-established. These hyaluronic acid injections have undergone rigorous testing and demonstrated their safety for patients with knee osteoarthritis. Although mild and temporary side effects are the usual outcome, serious adverse events are rare. Consulting with a healthcare provider is necessary for determining the best-suited option based on individual needs.

Key Considerations for Selecting Hyaluronic Acid Injections

To help you make the best choice, we’ll discuss the essential factors to consider. Regardless of whether you’re dealing with a knee, hip, or any other joint issue, understanding these key points will assist you in making an informed choice that aligns with your specific requirements.

  • Type of Joint Affected: A certain hyaluronic acid injection may be more appropriate than the other for specific joints. Your doctor will evaluate the affected area before choosing the right option for you.
  • Treatment Schedule: Consider your preference for a single injection or a series of injections. Some products also offer both options. Discuss your lifestyle and personal preferences with your doctor. 
  • Safety Profile: Evaluate your underlying health conditions, allergies, and the common side effects associated with the injections. 
  • Efficacy: Explore the product’s effectiveness in providing pain relief and improving joint function in the affected site. Each Hyaluronic Acid acts differently on different parts of the body.   
  • Treatment Duration: When evaluating the injections, consider the expected duration of pain relief. Some injections may offer longer-term benefits, while some offer short-term relief.
  • Personal Preferences: Discuss your individual preferences and needs with a healthcare provider to make a wise decision.

In summary, comparing hyaluronic acid injections for osteoarthritis treatment is all about finding the right fit for your needs. Each product, like Hyalgan, Synvisc, Euflexxa, Monovisc, and Orthovisc, has its strengths and weaknesses. Think about which joint is affected, the treatment schedule, safety, effectiveness, and your personal preferences. Your healthcare provider can offer guidance. Making an informed choice can lead to better joint function, pain relief, and an improved quality of life, so choose wisely for your osteoarthritis management.