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The principal advantage of NASHA is the single-injection treatment regimen, for both knee and hip OA. There are two factors that facilitate this: High initial dose of hyaluronic acid and extended residence time within the joint. The high dose is attributable to the physical properties of NASHA. The HA concentration is 20 mg/ml, far higher than other HA preparations, which are 5–10 mg/ml. Thus, every 3 ml injection of DUROLANE delivers 60 mg of HA. The extended intra-articular residence time of DUROLANE is due to the stabilisation process. Individual HA molecules are unable to move independently, which likely results in limited exposure to the cells that catabolise HA molecules. Following injection, free HA is gradually released from the beads over an extended period of time. There is no evidence of inflammatory reaction to DUROLANE, and is likely attributable to the non-animal source of NASHA and the mildness of the stabilisation process. In contrast, the extensive modification of other cross-linked HA products using a toxic chemical (divinyl sulfone) can potentially lead to an inflammatory reaction and, therefore, an increased rate of intra-articular degradation.

Durolane Syringe Side Effects: