In response to the number of requests for Synvisc information, I am attempting
to post the inservice presentation that I gave at Central Penn Sports Medicine
as a file attachment. This is merely what I found during my searches for
information on the product. I am attempting to attach the file as text only.
In the event that the attachment doesn't survive, here are some web sites that
I found most helpful:
http://www.virtualdrugstore.com/osteoarthritis/hylan.html
http://www.biomatrix.com/page4.htm (Biomatrix is the manufacturer of Synvisc)
http://www.towsonsportsmedicine.com/new.html
I hope that this helps. Best regards,
Christopher Carrier
[log in to unmask]
Inservice given: 1/28/98 Topic: Synvisc(
Synvisc(:Lube Job and Filter Change
I. Introduction
A. Manufactured by Biomatrix
B. Has received FDA approval as of August 13, 1997
C. General use: treatment (not cure) of osteoarthritis.
II. Background for treatment
A. Synovial fluid
1. Has consistency of egg whites. All around and in cartilage; helps to absorb shock.
2. Dilatent liquid- as force (shear) increases, so does viscosity.
3. Has a high concentration of hyaluronan (hyaluronic acid), among other things.
4. As we age, production of hyaluronan decreases. As a result, synovial fluid becomes thin and watery, thereby diminishing it's effectiveness as a shock absorber. The cartilage begins to take the brunt of the force and slowly erodes. This brings about pain and loss of function with the condition commonly known as osteoarthritis.
B. Osteoarthritis
1. "Wear and tear" arthritis. Cartilage erodes and bone begins to rub on bone.
2. This condition affects over 16 million Americans and is the leading cause of disability in the U.S.
3. More than 65% of the patients with this condition are over 65 years of age.
4. More men than women younger than 45 have it; once you get over 65, the number reverses and doubles (twice as many women as men have it).
5. 70% of all total hip and knee replacements are attributed to OA.
C. Current treatment of OA
1. Goals are to decrease pain while increasing ROM and function.
2. First step: weight loss and exercise.
3. Second step: medication. [progression from analgesics (Tylenol, etc.) to NSAIDs (Advil, Aleve, ketoprofen, etc.) to corticosteroid injections].
4. Third step: surgery [ranges from arthroscopic (clean it out) to total joint (take it out)].
III. Enter Biomatrix with Synvisc(
A. New form of therapy: viscosupplementation- modality by which ineffective synovial fluid is supplemented/replaced with a "biocompatible" liquid similar in design to healthy synovial fluid.
*This is not a drug. It is a last ditch effort to avoid total joint replacement.
B. Synvisc( is made of hylan polymers: chemically modified hyaluronan molecules. Hyaluronan is one of the substances found naturally in the body's synovial fluid that contributes to it's viscous and elastic nature. Hylan polymers are more viscous and more elastic than hyaluronan.
IV. Treatment plan
A. Contraindications: allergies to poultry products, egg products, feathers or known hyaluronan products. Knee infections or skin diseases or infections around joint.
B. Injections: three injections given directly into the joint (with no help from painkillers) within a span of 15 days. Each injection delivers 2 ml of Synvisc( to the joint.
C. Side effects: only localized pain/point tenderness, swelling and redness associated with the injection.
D. Drug interactions: Synvisc( is not a drug. It does not conflict or negatively interact with any of the drugs associated with the treatment of OA.
E. Exercise restrictions: none. It usually takes 3-9 weeks after the last injection to receive the full benefit of the treatment. Patient may continue with activity as tolerated.
F. Drawbacks: expense, demand, lack of long term study, and temporary nature of treatment. It is an expensive treatment, there's a waiting list (as of 1997), and it only lasts between 3-18 months. * The safety and effectiveness of Synvisc( has not been proven for either repeat cycles of treatment or use in children or pregnant/nursing women.
References:
http://www.virtualdrugstore.com/osteoarthritis/hylan.html
http://www.age-reversing-miracle.com/osteo1.htm
http://www.ama-assn.org/insight/spec_con/arthriti/arthrit2.htm#What
http://www.biomatrix.com/page4.htm
http://www.towsonsportsmedicine.com/new.html
http://www.kantata.com/secret.htm
wysiwyg://rbottom.51/http://www.Med.../Art.asp?li=MNI&ag=Y&ArticleKey=432
http://www.boulevardmall.com/www.repicci.com/knee1.html
http://www.healthtouch.com/level1/leaflets/acr/acr008.htm
http://www.ozbone.com/synvisc.htm
|