Monovisc vs Orthovisc – A Thorough Comparison

Last Updated On: September 30, 2024

Over 32 million adults in the United States suffer from osteoarthritis, making it one of the most common joint disorders. Treatments for osteoarthritis primarily aim to alleviate pain and improve joint function, with various options available to meet patient needs.

Among these treatments, Monovisc and Orthovisc stand out as popular hyaluronic acid injections for managing knee osteoarthritis. Both injections help lubricate the joint and reduce pain, but they differ in terms of administration and duration of relief, making it essential to understand their unique advantages. Consulting with a healthcare provider is critical to choosing the right treatment for individual needs.

In this article, we will compare Monovisc vs Orthovisc in detail, exploring their mechanisms of action, effectiveness, side effects, and patient suitability.

Key Takeaways

• Both are hyaluronic acid injections for knee osteoarthritis. Monovisc requires a single injection, while Orthovisc requires three injections over several weeks.
• Monovisc contains a high concentration of hyaluronic acid, while Orthovisc provides a gradual cumulative dose through multiple injections.
• Monovisc offers long-lasting relief, up to six months, from a single dose. Orthovisc provides gradual relief over time with a similar duration.
• Both treatments have low rates of adverse reactions, though side effects like swelling or discomfort may occur at the injection site.
• Monovisc may be better suited for patients seeking convenience, while Orthovisc could be ideal for those preferring a gradual treatment approach.

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Introduction to Monovisc and Orthovisc

Monovisc and Orthovisc are two viscosupplement treatments commonly used to manage knee osteoarthritis. While both aim to relieve pain and improve joint function, they differ in their administration schedules and formulation.

Monovisc is a single-injection treatment with a higher concentration of hyaluronic acid, making it a convenient option for patients who prefer fewer visits. On the other hand, Orthovisc requires a series of three injections over several weeks to achieve the same cumulative dose of hyaluronic acid.

Both treatments use moderate molecular weight hyaluronic acid to lubricate the knee joint, reduce friction, and alleviate pain. The choice between Monovisc and Orthovisc ultimately depends on patient preference and specific needs, offering effective solutions for individuals who haven’t responded to conservative therapies.

Formulation and Composition

Monovisc and Orthovisc are both viscosupplements designed to treat knee osteoarthritis by replenishing hyaluronic acid in the joint, but they differ in their formulation and administration schedule.

 Monovisc contains a single, high-concentration dose of non-animal sourced hyaluronic acid. Its formulation consists of high-molecular-weight hyaluronic acid (88 mg/4 mL), which mimics the natural synovial fluid in the knee, providing immediate lubrication and cushioning.

The single-injection treatment offers long-lasting relief, typically up to six months, and reduces the need for multiple visits to the doctor. The cross-linking process in Monovisc enhances the stability of hyaluronic acid, making it more durable within the joint.

In contrast, Orthovisc requires a series of three injections administered over several weeks. Each injection contains non-animal derived hyaluronic acid (30 mg/2 mL), which is of moderate molecular weight.

While the concentration per injection is lower than Monovisc, Orthovisc provides cumulative relief as the treatment progresses, offering patients the benefits of sustained, gradual improvement in knee function and pain reduction.

Efficacy in Treating Osteoarthritis

Clinical studies have demonstrated Monovisc’s efficacy and safety, showing significant improvement in pain relief compared to saline. The convenience of a single high-dose injection makes Monovisc an attractive option for patients seeking a straightforward and effective treatment for knee OA. Additionally, post-marketing safety data supports its use, highlighting its role in improving the viscoelastic properties of synovial fluid, protecting cartilage, and reducing inflammation.

Through various clinical trials, Orthovisc has also significantly improved pain and function in knee osteoarthritis (OA) patients. A meta-analysis and multiple studies confirm its efficacy and safety, highlighting its role in reducing pain and enhancing joint function. Orthovisc’s effectiveness is supported by comprehensive reviews and randomized controlled trials, making it a reliable treatment option for OA.

Safety and Side Effects

Both Monovisc and Orthovisc have well-established safety profiles, making them popular options for knee osteoarthritis treatment. Despite their overall safety, it’s important to be aware of potential side effects, ranging from mild to serious.

Common Side Effects

• Injection Site Discomfort: Patients may experience temporary pain, swelling, or redness at the injection site for both Monovisc and Orthovisc. These symptoms typically resolve within a few days without intervention.
• Mild Swelling: It is common to have mild swelling around the knee, which can be managed with ice or over-the-counter pain relief.

Rare but Serious Adverse Reactions to the Treatments

• Allergic Reactions: Though uncommon, some individuals may experience allergic reactions, such as hives, itching, or difficulty breathing. This requires immediate medical attention.
• Infection: There’s a small risk of infection following injection, often presenting as severe pain, redness, or swelling at the site. Medical evaluation is crucial if these symptoms occur.
• Joint Damage: A small number of patients may report increased joint pain or damage post-injection, emphasizing the need for healthcare providers to assess risks thoroughly.
• Nerve Injury: Rare cases of nerve injury may result in tingling or numbness around the knee area. This is typically reversible but should be closely monitored.
• Blood Clots: Deep vein thrombosis (DVT) is a rare but serious risk, where patients may experience leg pain or swelling. Immediate medical intervention is advised in these cases.
• Vascular Injury: There is a minor risk of vascular injury, which could cause discoloration or persistent pain. Immediate care is necessary if such symptoms arise.
• Systemic Reactions: Though extremely rare, some patients may experience systemic reactions like fever, fatigue, or muscle pain, requiring urgent attention.
• Anaphylaxis: In extremely rare cases, a severe anaphylactic reaction can occur, requiring emergency treatment.

Comparison of Safety Profiles

• Monovisc vs Orthovisc: Both treatments are considered safe and effective, with a similar profile of side effects. However, since Monovisc is administered in a single injection and Orthovisc requires three injections, Monovisc may present a lower overall risk of complications due to fewer injection sites.
• Incidence of Adverse Events: Studies indicate that both treatments have a low incidence of adverse events. However, patients allergic to avian proteins may be at higher risk with Orthovisc, as it contains hyaluronic acid derived from non-animal sources.

Patient Tolerance and Satisfaction

Both Monovisc and Orthovisc are well-tolerated by most patients, making them popular choices for managing knee osteoarthritis. The key differences in treatment duration and injection frequency influence patient satisfaction levels, as they cater to different preferences regarding convenience and results.

According to Monovisc injection reviews, many patients appreciate the ease of only needing one visit for the full course of treatment. This reduces the inconvenience of multiple doctor appointments, and many patients report experiencing significant pain relief for up to six months following the Monovisc knee injection.

On Monovisc

• Burk: “I had a Monovisc injection almost 3 years ago after being told by my first doctor I needed knee replacement…He also explained that this only helps 50-60% of the people who take it. I am happy to say it has helped me.”

On the other hand, Orthovisc requires a series of three injections, spaced one week apart. While some patients may find this regimen more demanding, many appreciate the gradual buildup of relief it provides. Orthovisc has shown high efficacy in improving knee function and reducing pain, leading to high levels of patient satisfaction for those willing to commit to the longer treatment protocol.

On Orthovisc

• Mare: “I’m 72 with bone-on-bone osteoarthritis in my knees. Orthovisc has been a miracle for me. I got THREE YEARS of relief! I know it doesn’t work for everyone, but I feel like a really lucky girl that it works for me. Good luck, everyone!”

In terms of overall patient tolerance and satisfaction, Monovisc may be preferred by individuals who seek a one-and-done approach, whereas Orthovisc appeals to those who favor a more gradual treatment process.

Both options effectively alleviate knee pain and improve joint mobility, though patient preferences for treatment duration and the number of injections play a crucial role in determining satisfaction.

Conclusion

Monovisc and Orthovisc are both effective hyaluronic acid-based viscosupplements designed to relieve osteoarthritis symptoms, each with distinct advantages. Monovisc provides the convenience of a single injection, while Orthovisc involves three injections for a more gradual treatment. Patient preferences and responses can vary, so it’s essential to consider individual needs when choosing the right therapy. 

Consulting a healthcare professional ensures a personalized approach, helping patients make informed decisions to achieve the most effective knee pain relief.

FAQs

1. How does Monovisc work compared to Orthovisc?

Monovisc is a single-injection treatment with a high concentration of hyaluronic acid, providing immediate lubrication and cushioning for the knee joint. Orthovisc, however, requires three injections spaced out over several weeks to achieve the same effect.

2. What are the common side effects of Monovisc and Orthovisc?

Common side effects include temporary discomfort, swelling, or redness at the injection site. These effects typically resolve within a few days.

3. Can Monovisc or Orthovisc cause allergic reactions?

Though rare, allergic reactions, such as hives or difficulty breathing, can occur. If any allergic symptoms arise, it’s crucial to seek immediate medical attention.

4. Is one treatment more effective than the other?

Both Monovisc and Orthovisc are effective for treating knee osteoarthritis. The choice depends on patient preference, with Monovisc offering convenience through a single injection and Orthovisc providing a gradual build-up of relief.

References

Mayo Clinic. Osteoarthritis – Diagnosis and treatment. Published June 16, 2021. https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930 

Dunkin MA. Treatments for Osteoarthritis. Arthritis Foundation. Published June 15, 2022. https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/treatments-for-osteoarthritis