- Supartz (Sodium Hyaluronate)
- Supartz Injection Technique For The Knee Joint
- 1. Examination Of The Knee
- 2. Marking The Injection Site
- 3. Sterilization Of The Injection Site
- 4. Anesthetizing The Skin
- 5. Aspirate Any Existing Joint Fluid
- 6. Injection Of Supartz
- 7. Remove Betadine and Apply Band-Aid
- Related web links:
- Hyaluronic Acid Injections: How Do They Treat Arthritis?
- What Is Hyaluronic Acid, and What Does It Do?
- Why Would an Arthritis Patient Get Hyaluronic Acid Injections vs. Other Treatments?
- Is It Worth Getting Hyaluronic Acid Shots to Delay a Knee Replacement? Should You Just Get the Surgery?
- Where Are Hyaluronic Acid Shots Given? Do They Hurt?
- How Long Does Relief Last?
- What Are the Side Effects of Hyaluronic Acid Shots?
- Why Don’t Some Medical Groups Recommend Hyaluronic Acid Shots?
- Keep Reading
- Knee Injections
- What Is Supartz and a Supartz Injection?
- Denver Supartz Injections
- Knee injection – Supartz
- What is the use of knee injection?
- What is Supartz knee injection?
- How Supartz knee injection works?
- Is Supartz knee injection safe?
- Who can take Supartz knee injection?
- Are there any side effects of Supartz?
- Supartz (injection)
- What is Supartz?
- Important Information
- Before taking this medicine
- How is Supartz given?
- What happens if I miss a dose?
- What happens if I overdose?
- What should I avoid after receiving Supartz?
- Supartz side effects
- What other drugs will affect Supartz?
- Further information
- More about Supartz (sodium hyaluronate)
I have been told by my DR he might start 5 weeks of SUPARTZ injections in my right knee in 6 weeks. My question is How effective are these injections since my DR does not tell me it is a cure. He still says I could need replacement. Why would I need to go through these weeks of injections if it is only going to give me possibly a little time before total replacement?
Supartz and the similar drugs Hyalagan and Synvisc are synthetic versions of hyaluronic acid, the normal lubricant in the knee. The exact mechanism of how these drugs work when injected into the knee is unknown, but they may stimulate the cartilage to grow. It is difficult to predict who will respond. I tell my patients that the overall response is about 50%, with patients with less severe disease on x-ray doing better. There are some who do absolutely great while others get no reponse. The risk of the injections is very low (although admittedly the injections are no fun) and thus patients are often willing to try. It is not a cure and when there is a response, it can last from 9-12 months.
Supartz (Sodium Hyaluronate)
Supartz – is a solution of hyaluronate, a natural substance that acts like “oil” to cushion and lubricate your knee joint.
Supartz is injected directly into the knee. Just a single course of treatment (five injections given weekly) can provide long-lasting pain relief.
SUPARTZ has been in use since 1987 and approximately 143 million injections given.
SUPARTZ is the most prescribed Joint Fluid Therapy in the world. Supartz is a natural chemical of highly purified Sodium Hyaluronate that comes from rooster combs. It is in the classification of medications that are referred to as visco supplements. Hyaluronate is a natural chemical found in the body and is present in particularly high amounts in joint tissues and in the fluid that fills the joint itself.
The body’s own hyaluronate is a lubricant and shock absorber in the joint and is needed for the joint to work properly.
In osteoarthritis there is usually a reduction in hyaluronate in the tissues and the joint and there may be a change in the quality of the hyaluronate itself.
Supartz is used to relieve the pain due to osteoarthritis in the knee joint. Like other visco supplements, it is only used if the patient has not obtained adequate relief from simple pain medication, exercise, or possibly physical therapy. Supartz contains natural Sodium Hyaluronate and is not chemically modified in any way. Acute inflammatory reactions have not been reported with Supartz.
Supartz is different from the other visco supplements in that it most closely resembles the hyaluronate of a healthy knee joint. It is injected once per week for a total of five injections rather than three injections.
The manufacturer of Supartz has determined, through investigational studies, that the duration of benefit from a course of therapy can be as long as twelve months which is longer than the other preparations that are available. The manufacturer believes that by using five injections rather than three, the duration of pain relief can in many cases be doubled. Supartz is the only preparation which is allowed to state that their product can relieve symptoms for up to twelve months.
Supartz has been in use throughout the world for more than 12 years. Supartz is also approved for re-treatment if the first course of therapy loses its affect.
Some patients have begun to experience pain relief after the third injection of Supartz. For others, however, pain relief was not seen until after the fifth injection or beyond.
For 48 hours after the injection is administered, it is probably best to avoid activities such as jogging, heavy lifting, sporting activities, or standing or being on your feet for a long period of time. Discomfort from the injection is usually controlled by the application of ice.
Supartz is administered directly into the knee joint after the skin and subcutaneous tissue are anesthetized with a local anesthetic. Over the counter pain medications are all that is required following the injection in the great majority of patients.
We are often asked by patients why they would want to have a preparation that required five injections rather than three. The answer is that the potential duration of pain relief is significantly greater with Supartz than with the other preparations. This, of course, is not guaranteed, but in studies of very large numbers of patients this fact has been found to be true and Supartz has proven to be the safest hyaluronate on the market and does not cause acute inflammatory reactions aka “Hot Knees”.
Supartz has recently developed a 3-injection regimen that is now available. This is also very effective in relieving pain in knee, but cannot be expected to last as long as the 5-injection regimen.
Supartz Injection Technique For The Knee Joint
Supartz (Sodium Hyaluronate) is injected into the knee joint as a series of five injections. Each injection is administered once a week on the same day. The following is the procedure that has been used in the office of Thomas Haverbush, M.D., P.C. for the last two years. We present this in order that the patient with osteoarthritis of the knee, who is to undergo the Supartz injection series, can understand exactly how it is done in our office.
The following is a description of the technique and pictures of the right knee being injected from the medial side.
1. Examination Of The Knee
The knee is examined to determine the landmarks, particularly the location of the patella, on the anterior aspect of the knee. The medial border of the patella is identified from this examination.
2. Marking The Injection Site
A small plastic circular marker is used to indent the skin definitely marking the injection site that has been determined from examination of the knee.
3. Sterilization Of The Injection Site
Betadine swab sticks are used to sterilize the injection site. The sterile area is at least 6cm in diameter and three swabs are used for the preparation of the area.
4. Anesthetizing The Skin
3 cc. of 1% Xylocaine are injected with a 25 gauge needle, anesthetizing the skin, subcutaneous tissue, capsule, and synovium. We then wait ten minutes for the injected area to become fully anesthetized. Waiting this length of time has been very helpful in assuring maximum comfort during the injection of the Supartz in most patients.
5. Aspirate Any Existing Joint Fluid
When the 18 gauge needle is inserted into the knee, prior to injection of the Supartz, any joint fluid that exists in the knee that can be aspirated is removed.
6. Injection Of Supartz
2 cc. OF Supartz (Sodium Hyaluronate) is injected with an 18 gauge needle directly into the knee joint. By using an 18 gauge needle, it is possible – with experience – to be sure that you are injecting the Supartz directly into the knee joint cavity rather than into the soft tissue in or around the knee joint.
7. Remove Betadine and Apply Band-Aid
After the needle which was used to inject the Supartz is withdrawn, the knee is wiped clean of Betadine and pressure is held over the injection site until all bleeding has stopped. Usually there is a very minimal amount of bleeding that results from the injection. A band-aid is then applied and the procedure is over.
We believe this technique has worked very well for over two years and has resulted in minimal discomfort for our patients.
On the day of injection the patient is instructed to be sensible in his or her activities and to not walk more than is necessary for their activities of daily living on that day. They do not need to use a cane or crutch and can bend the knee as they wish.
After the fifth and last injection in the series is administered, we routinely make an appointment to see the patient back in the office in six weeks for follow-up.
Most of our patients have begun to experience some relief of knee pain during the injection series. Some do not experience relief until the series is completed. One of our patients did not experience any relief of symptoms for six weeks.
A small number of patients have experienced no relief of pain. In those patients their osteoarthritis process is probably too advanced for viscosupplementation to help and we have asked Supartz to do more than it is capable of doing.
Overall, we are impressed with the relief that patients obtain from Supartz and we continue to use it regularly when orthopaedically indicated.
Hyaluronic Acid Injections: How Do They Treat Arthritis?
You’ve tried all the conservative therapies for your knee osteoarthritis, and nothing is working. You really, really don’t want to go down the knee replacement surgery road yet. What’s left to try? You might want to consider hyaluronic acid injections for your knee osteoarthritis (OA). Be warned, though: Their effectiveness is up for debate, with medical research not quite backing up how well they work.
Yet, individual patients have reported relief from their arthritis pain with the shots — but not everyone. Even a CreakyJoints Facebook post soliciting feedback on patients’ experiences received responses ranging from “they worked like a dream” and “amazing” to “they did nothing to relieve my OA knee pain” and even “they made my knee worse.”
Read on to find out more and decide if hyaluronic acid injections are worth a “shot” (sorry, bad pun intended) for you.
What Is Hyaluronic Acid, and What Does It Do?
Hyaluronic acid, also known as hyaluronan, is a gel-like substance naturally present in the synovial fluid that lubricates your joints. Because arthritis patients lose hyaluronic acid as their joint wears away, the theory goes that replacing it with a process called viscosupplementation would make using the joint less painful. The injections are FDA-approved for knee osteoarthritis.
“Its mechanism of action is not fully known, but is thought to at least temporarily increase the viscosity, or thickness, of the fluid that surrounds the joint it is injected into,” says Donald Miller, PharmD, a professor at the School of Pharmacy at North Dakota State University. “This may reduce pain and make joint movement easier.”
You can think of it like WD-40 for your joints.
Why Would an Arthritis Patient Get Hyaluronic Acid Injections vs. Other Treatments?
Typically, you would try other conservative treatments first, like weight loss, exercise, NSAID medications, and steroid injections. If those don’t help, hyaluronic injections may be an option.
Some patients might have other conditions for which for first-line treatments would be contraindicated. Some doctors might use hyaluronic acid injections along with steroid injections as well. “I had the injection every week for three weeks along with cortisone injections,” Sharon Ruoto told us on Facebook. “I did this every six months for years.”
Although hyaluronic acid is also available as a pill, the shots are usually preferred. “Advantages are targeted relief to the joint with no systemic side effects from pills, and the convenience of not taking pills by mouth,” Dr. Miller says. Brand names of the hyaluronic acid shot include Euflexxa, Supartz, and Synvisc-One.
Is It Worth Getting Hyaluronic Acid Shots to Delay a Knee Replacement? Should You Just Get the Surgery?
Hyaluronic acid injections are often a last-ditch effort before knee replacement surgery. “It bought me a year before replacements,” Cathy Anderson Eberhardt told us on Facebook. But because the shots don’t actually appear to affect the disease progression, some medical professionals think they just put off the inevitable, and only serve to tack on additional health care costs. “For some people it can delay surgery or can avoid it altogether, but hyaluronans will generally not avoid eventual surgery in badly affected knees,” Dr. Miller says. But, they “will be helpful in patients not quite mentally ready for surgery.”
Where Are Hyaluronic Acid Shots Given? Do They Hurt?
If you are going to get hyaluronic acid injections, the actual process is fairly simple. “They are directly injected into the affected knee joint, specifically within the synovial fluid that bathes the joint,” Dr. Miller says. “Like any injection, it may seem more painful to some people than others, but there should not be a lot of pain since a sharp needle is used and the joint may be numbed first with a local anesthetic.”
How Long Does Relief Last?
“It is quite variable but many patients report six months of relief, and the injections may be repeated every six months or based on physician judgement,” Dr. Miller says. Our Facebook community confirms this, with most patients telling us relief lasted from four to six months; they got the shots (or series of shots) every six months. But, as Sarah Quina shared, “they don’t work repeatedly forever.” Also, the shots may take several weeks to go into effect, unlike steroid injections, which work much faster.
What Are the Side Effects of Hyaluronic Acid Shots?
The shots are usually low risk, but some side effects may occur. “Typical side effects include pain, swelling, heat, redness, and/or fluid build-up around the knee,” Dr. Miller says. “Rest and ice afterward can help prevent the typical side effects.”
More rarely, infections of the joint are possible, as is damage to other parts of the knee, he says. “However, properly trained physicians will deliver an injection with very little risk of complications,” Dr. Miller says.
Why Don’t Some Medical Groups Recommend Hyaluronic Acid Shots?
Even though some patients have gotten relief from these shots, some professional organizations, such as the American Academy of Orthopaedic Surgeons, don’t recommend them due to the lack of robust scientific evidence of their effectiveness. “Some studies have found these injections are not more effective than placebo injections,” Dr. Miller says. “However patients get a lot of relief from placebo effects of any injection, so this makes it difficult to show the independent effect of the hyaluronan.” In addition, given the expense of hyaluronan injections, he says, many insurance companies are reluctant to pay for something only a little better than placebo. “I pay for them from Canada because my insurance won’t cover,” Quina told us on FB.
If you’re interested in hyaluronic acid injections for your OA, talk to your doctor and check with your insurance company to see if they may be an option for you.
- 7 Knee Exercises to Ease Arthritis Pain
- Learn the Difference Between Osteoarthritis and Inflammatory Arthritis in Your Knees
- The Worse Your Arthritis Knee Pain, the More Likely Your Disease Will Progress
Since 1987, more than 143 million patients have found relief from knee pain thanks to a knee Supartz injection. At Denver Physical Medicine & Rehab, we provide Denver Supartz injections for patients who suffer from chronic knee pain from osteoarthritis.
What Is Supartz and a Supartz Injection?
Supartz is a natural chemical made of highly purified sodium hyaluronate, which comes from rooster combs. When injecting Supartz directly into the knee, it acts like an “oil” to lubricate and cushion the knee joint. A typical course of treatment consists of five weekly injections and provide long-lasting pain relief for arthritis sufferers.
Hyaluronate occurs naturally within our bodies, and it is found in especially high concentrations in joint tissue and the fluid that fills the joint. It is necessary for proper joint function and to lubricate the joint and absorb shock. In patients with osteoarthritis, there is typically a reduction in hyaluronate. This contributes to pain and decreased mobility.
Supartz injections are frequently used to relieve knee pain caused by osteoarthritis. It is the most commonly prescribed joint fluid therapy in the world, and it is often effective for patients who have not achieved the desired results from exercise, physical therapy in Denver or pain medication.
When you visit Denver Physical Medicine & Rehab for knee Supartz injections, we will numb the skin and subcutaneous tissue prior to injecting Supartz into your knee joint. Discomfort from the injection can typically be managed with over-the-counter pain relievers. You should avoid jogging, being on your feet for long periods of time and heavy lifting for 48 hours following the injection.
Many patients begin experiencing relief following the third injection, but you may need to complete the entire series before you receive the maximum benefit of Supartz injections. The results can last for up to 12 months.
If you are suffering from chronic knee pain from osteoarthritis, please contact Denver Physical Medicine & Rehab today. Call 303-757-7280 to schedule your free initial consultation.
Knee injection – Supartz
What is the use of knee injection?
Knee injections are used to relieve pain when medication is unable to reduce pain and patients do not want to opt for surgery. Osteoarthritis, Inflammation causes the knee pain which affects the life of the patient by making it uncomfortable. Knee pain influences the routine activities of the person. Knee injections can be the alternative for surgery.
What is Supartz knee injection?
Supartz knee injection is a disc supplement. It is a derivative of hyaluronic acid. Supartz injection contains an injectable solution formed of purified sodium hyaluronate which is also known as hyaluronic acid. Sodium hyaluronate is extracted from chicken and rooster combs. Supartz injection is a nonpharmacologic and nonsurgical therapy to relieve knee pain and improve the range of motion.
How Supartz knee injection works?
Knee contains synovial fluid which provides lubrication and cushioning. Supartz when injected into the knee, it replaces lost or diseased synovial fluid in the knee joint. The cause of knee pain is diseased synovial fluid so when it is replaced by Supartz solution, it reduces the pain. The specific target of Supartz solution is osteoarthritis pain in the knee.
Is Supartz knee injection safe?
Common Supartz treatments have not shown any side effects. Most patients who received Supartz injection are satisfied and experienced improved mobility and reduced pain. Multiple clinical studies indicate effectiveness of Supartz and it is as safe as saline. Till now more than 350 million Supartz injections are administered worldwide.
Who can take Supartz knee injection?
Supartz knee injection is the right treatment for those people who have:
- Osteoarthritis knee pain
- Pain during knee movement
- Joint inactivity or soreness
- Not getting knee pain relief from physical therapy, walking or exercise
- Not feeling relieved even after taking pain medications such as ibuprofen, naproxen, and acetaminophen.
- Don’t want to go for knee replacement or surgery
Are there any side effects of Supartz?
Some patients have experienced some minor side effects after receiving Supartz knee injection. Side effects include stiffness, puffiness or swelling at the site of injection, headache, stomach pain, back pain, numbness, and tiredness.
Medically reviewed by Drugs.com on Mar 27, 2018 – Written by Cerner Multum
- Side Effects
What is Supartz?
Supartz is similar to the fluid that surrounds the joints in your body. This fluid acts as a lubricant and shock absorber for the joints.
Supartz is used to treat knee pain caused by osteoarthritis.
Supartz is usually given when other arthritis medications have not been effective.
Supartz may also be used for purposes not listed in this medication guide.
You should not receive a Supartz if you have an infection in your knee or in the skin around your knee.
Before taking this medicine
You should not receive Supartz if you are allergic to it, or if you have an infection in your knee or in the skin around your knee.
Supartz is not approved for use by anyone younger than 21 years old.
Tell your doctor if you have ever had:
blood clots or circulation problems in your legs; or
an allergy to birds, feathers, or egg products.
It is not known whether Supartz will harm an unborn baby. Tell your doctor if you are pregnant.
It may not be safe to breast-feed a baby while you are using this medicine. Ask your doctor about any risks.
How is Supartz given?
Supartz is injected directly into your knee joint. A healthcare provider will give you this injection.
Supartz is usually given once every week for 3 to 5 weeks. Follow your doctor’s dosing instructions very carefully.
To prevent pain and swelling, your doctor may recommend resting your knee or applying ice for a short time after your injection.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Tell your doctor if your symptoms do not improve, or if they get worse.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your Supartz.
What happens if I overdose?
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid after receiving Supartz?
For at least 48 hours after your injection, avoid jogging, strenuous activity, or high-impact sports such as soccer or tennis. Also avoid weight-bearing activity or standing for longer than 1 hour at a time. Ask your doctor how long to wait before you resume these activities.
Supartz side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
severe pain or swelling around the knee after the injection.
Common side effects may include:
warmth, pain, redness, stiffness, bruising, or puffiness where the medicine was injected;
nausea, stomach pain;
swelling in your hands or feet;
back pain, joint pain, muscle pain;
numbness or tingly feeling;
headache, dizziness; or
runny or stuffy nose, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Supartz?
Other drugs may affect Supartz, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
- Your doctor can provide more information about Supartz.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2018 Cerner Multum, Inc. Version: 4.02.
More about Supartz (sodium hyaluronate)
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- En Español
- 41 Reviews
- Drug class: viscosupplementation agents
- Supartz (Advanced Reading)
Other brands: Euflexxa, Hyalgan, Durolane, Gelsyn-3, Supartz FX
Related treatment guides
The evaluable for safety population included all patients receiving at least one injection (532 SUPARTZ FX 5; 87 SUPARTZ FX 3; 537 control injection) in five well controlled clinical trials. The most common adverse events occurring in SUPARTZ FX-treated patients were arthralgia, defined as joint pain with no evidence of inflammation, arthropathy/ arthrosis/arthritis, defined as joint pain with evidence of inflammation, back pain, pain (non-specific), injection site reaction, headache, and injection site pain (See Table 1). There were no statistically significant differences in the incidence rates of these adverse events between treatment groups.
Five (5) allergic reactions were reported in the SUPARTZ FX group. All five events were classified as mild to moderate. These were: hayfever (2), reaction on face and neck, cutaneous reaction forearms and knees, and an undefined mild allergy reaction. No anaphylactic reactions were observed in any study patients. Other adverse events occuring in 4% or less but not less than 1% of the SUPARTZ FX treated patients included upper respiratory tract infection, influenza-like symptoms, nausea, sinusitis, urinary tract infection, bronchitis, abdominal pain, diarrhea, inflicted injury, leg pain, discomfort in legs, dyspepsia, dizziness, rhinitis, and fall.
SUPARTZ FX (ARTZ) has been in use in Japan since 1987. A prospective post-market surveillance study1 conducted from 1987 to 1993 evaluated safety on 7404 knees treated from a total of 675 medical institutions. A subset of 7155 knees was treated with 3 or more consecutive injections. There were 58 cases of adverse reactions in 37 knees (0.50% – 37/7404). The most frequently observed were 29 cases of pain at the injection site, 16 cases of swelling, and 3 cases of redness. Other adverse reactions were 3 cases of rash, 3 cases of increased serum GPT, 2 cases of increased serum GOT, 1 case of itching, and 1 case of increased Al-P. The incidence of adverse reactions was not related to the number of injections. There was no increase in adverse events in patients requiring 3 or more injections.
Adverse experience data from the literature contain no evidence of increased safety risk relating to retreatment with SUPARTZ FX. The frequency and severity of adverse events occurring during repeat treatment cycles did not increase over that reported for a single treatment cycle.
The following possible adverse reactions have been reported worldwide.
- The most common adverse reactions include: Injection site reactions (pain / swelling / effusion / redness / warmth). Rare cases of severe reactions have been reported.
- Other adverse reactions include: Itching; swelling of the face, eyelids, mouth and/or extremities; rash; hives; redness in face; nausea; vomiting and fever. Anaphylactic/anaphylactoid reactions accompanied by transient hypotension (sudden drop in blood pressure), have been rarely reported, all of which resolved either spontaneously or after conservative treatment.
Table 1: Adverse Events Occurring in > 4% of SUPARTZ FXtreated Patients
Table 1A: Adverse Events Occurring in 3-Injection SUPARTZ FX-treated Patient
Read the entire FDA prescribing information for Supartz FX (Sodium Hyaluronate Solution)