A 2021 study by the EUROVISCO group found that viscosupplementation can be an effective treatment option for mild to moderate knee osteoarthritis (OA), particularly for patients not fit for surgery. While not intended as a replacement for joint replacement in advanced cases, viscosupplementation—using hyaluronic acid to improve lubrication and cushion within the joint—can significantly reduce pain and enhance mobility, making everyday movement more comfortable.
Among the available options, Cingal and Monovisc are two popular viscosupplement brands, each with unique formulations designed to support joint health. While both are safe and effective, they have different compositions, mechanisms of action, and injection protocols.
In this article, we’ll compare Cingal vs Monovisc, exploring their formulations, mechanisms, and how they may benefit patients with knee OA.
Key Takeaways
- Osteoarthritis is a degenerative joint disease resulting from the breakdown of cartilage, leading to increased joint friction.
- When conservative therapies, like physical therapy or oral medications, prove ineffective, physicians may suggest viscosupplementation.
- Cingal leverages the combined benefits of hyaluronic acid and corticosteroid in its formulation to deliver both immediate and long-lasting relief from knee osteoarthritis symptoms.
- Monovisc exclusively contains high-molecular-weight hyaluronic acid in its formulation.
- When comparing the performances of Cingal and Monovisc at 1 and 3 weeks, Cingal outperformed Monovisc for most endpoints in terms of pain relief and joint mobility.
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Understanding Osteoarthritis and Treatment Options
Osteoarthritis (OA) is a progressive joint disease caused by the gradual breakdown of cartilage, which leads to increased joint friction. Common symptoms include chronic pain, stiffness, inflammation, and reduced mobility. While OA most frequently affects the knees, it can also impact other joints, including the hips, hands, and spine.
There is currently no cure for OA, but early intervention and treatment are essential. By addressing symptoms early, patients can often slow the disease’s progression and maintain better joint function. Physicians typically start with conservative therapies, including medications, physical therapy, and lifestyle changes. For severe cases, surgery may be considered.
When these conservative treatments become less effective, medical professionals may recommend viscosupplementation. This minimally invasive treatment, which injects hyaluronic acid into the joint, aims to improve lubrication, reduce pain, and enhance mobility without surgical intervention.
Cingal and Monovisc
Viscosupplementation is a treatment that involves injecting hyaluronic acid (HA) directly into the joint to help with knee osteoarthritis (OA). Two popular options for this are Cingal and Monovisc, each with its own approach to providing pain relief and improving mobility.
Composition
Cingal and Monovisc aim to make moving around with OA easier, but they’re formulated differently. Cingal stands out because it combines hyaluronic acid with a corticosteroid, which means it tackles pain from two angles: the hyaluronic acid helps cushion and lubricate the joint, while the corticosteroid gives an extra boost by reducing inflammation right away.
In contrast, Monovisc sticks with just hyaluronic acid—specifically, a high-molecular-weight version that’s closer to what’s naturally found in the joint. It’s designed to improve joint lubrication and function over time, though it may take slightly longer to feel the effects than Cingal.
Injection Protocol
Both Cingal and Monovisc require only a single injection, which is convenient for people who want relief without multiple trips to the doctor. However, since it’s an intra-articular injection (meaning it goes directly into the knee joint), it’s essential that a trained healthcare provider administer it. This helps ensure the injection is given accurately and safely, maximizing the potential benefits.
Mechanism of Action
While Cingal and Monovisc work in similar ways by replenishing hyaluronic acid in the joint, they each have their own pace when it comes to providing relief. Both injections restore the lubrication and cushioning that help reduce pain and improve movement, but Cingal’s corticosteroid component means that many patients feel relief almost right away.
Monovisc, being pure hyaluronic acid, may take a few days to kick in fully, but it also provides a lasting effect that many find effective for managing OA symptoms over time.
Comparing Effectiveness and Patient Outcomes
A study revealed that Cingal offers immediate and long-term relief from osteoarthritis-related pain, stiffness, and functional impairment, with significant effects lasting up to 26 weeks compared to saline. It provides immediate benefits to HA alone and maintains comparable advantages at 6 weeks and beyond.
Additionally, the study compared Cingal and Monovisc, revealing that Cingal outperformed Monovisc at 1 and 3 weeks for most endpoints. However, from week six to 26, both treatments showed similar results.
Meanwhile, Monovisc’s single-injection intra-articular hyaluronic acid (HA) device has proven its clinical efficacy by significantly reducing knee pain within two weeks. This study underscores Monovisc’s safety and effectiveness as an alternative treatment for symptomatic knee osteoarthritis in patients aged 45 and older.
Patient Outcomes
Limited patient testimonials and outcomes demonstrate the efficacy of Cingal and Monovisc treatments. Several patients have shared their positive experiences with these viscosupplements, highlighting their effectiveness in addressing knee osteoarthritis symptoms.
Safety Profiles and Patient Satisfaction
When comparing Cingal vs Monovisc, a thorough consultation with a medical professional allows patients to understand the safety profiles. While both treatments are well-tolerated, patients should know potential Monovisc and Cingal side effects may occur. These typical reactions are often temporary and may resolve within a few days to a week.
- Common Cingal Side Effects: Mild pain at the injection site, joint discomfort, rash, redness, or swelling
- Common Monovisc Side Effects: Swelling and temporary discomfort
These viscosupplements rarely lead to persistent or unexpected symptoms, such as allergic reactions or infections. Medical professionals must avoid administering Cingal or Monovisc when patients have contraindications, which may result in further complications.
Limited research directly measures patient satisfaction for Cingal and Monovisc. However, patients report positive results with these injections, particularly when administered by qualified healthcare providers who ensure both safety and effectiveness.
Conclusion
When it comes to treating osteoarthritis, both Cingal and Monovisc offer effective relief, but their formulations suit different needs. Cingal combines hyaluronic acid with a corticosteroid, giving it an edge for those who want both quick and long-lasting relief from pain and stiffness. It’s often a great option for patients looking for a faster response right from the start.
Meanwhile, Monovisc focuses solely on high-molecular-weight hyaluronic acid, making it a reliable choice for patients who benefit from straightforward viscosupplementation. In the end, deciding between Cingal and Monovisc comes down to what each patient needs, how they respond to treatment, and the guidance of their healthcare provider.
FAQs
1. What are Cingal and Monovisc used for?
Cingal and Monovisc are both viscosupplement treatments for managing osteoarthritis (OA) symptoms, particularly in the knee. They aim to relieve pain, stiffness, and inflammation resulting from joint cartilage breakdown.
2. How do Cingal and Monovisc differ in their formulations?
Cingal combines hyaluronic acid and corticosteroid, offering both immediate and long-lasting relief. In contrast, Monovisc contains only high-molecular-weight hyaluronic acid, which mimics the natural synovial fluid to alleviate OA symptoms.
3. Which treatment shows better results for knee osteoarthritis?
Studies indicate that Cingal outperforms Monovisc at the one—and three-week marks in providing symptomatic relief. However, between weeks six and 26, both treatments exhibit similar effectiveness in managing knee osteoarthritis symptoms.
References
- Conrozier, T., Raman, R., Chevalier, X., Henrotin, Y., Monfort, J., Diraçoglù, D., Bard, H., Baron, D., Jerosch, J., Richette, P., & Migliore, A. (2021). Viscosupplementation for the treatment of osteoarthritis. The contribution of EUROVISCO group. Therapeutic advances in musculoskeletal disease, 13, 1759720X211018605. https://doi.org/10.1177/1759720X211018605
- Hangody, L., Szody, R., Lukasik, P., Zgadzaj, W., Lénárt, E., Dokoupilova, E., Bichovsk, D., Berta, A., Vasarhelyi, G., Ficzere, A., Hangody, G., Stevens, G., & Szendroi, M. (2017). Intraarticular Injection of a Cross-Linked Sodium Hyaluronate Combined with Triamcinolone Hexacetonide (Cingal) to Provide Symptomatic Relief of Osteoarthritis of the Knee: A Randomized, Double-Blind, Placebo-Controlled Multicenter Clinical Trial. CARTILAGE, 9(3), 276–283. https://doi.org/10.1177/1947603517703732
