Hyaluronic acid

(or hyaluronan according to the new nomenclature) Synvisc®, Synvisc-One®, Cingal®.

Hyaluronic acid

Hyaluron therapy can have a beneficial effect on:

  • Omarthrosis (shoulder joint wear and tear)
  • Gonarthrosis (knee joint wear)
  • Ankle joint wear
  • Coxarthrosis (hip joint wear)


Hyaluronic acid is a glycosaminoglycan and occurs in the extracellular matrix (ECM) of vertebrates. Nowadays, it is obtained from animal source material (e.g. cockscomb) or biotechnologically from streptococcal cultures. Hyaluronic acid is injected directly into the joint as a viscous lubricant and shock absorber to prevent further wear in joint wear diseases (osteoarthritis) and to reduce irritation and pain.


The Synvisc-One® cartilage-protecting syringes used contain one of the basic substances of articular cartilage, hyaluronic acid. This substance is injected into the respective joint under sterile conditions. Simultaneous treatment of several joints and repeated treatment cycles are possible. For the knee joint, we recommend three injections of 2ml Synvisc® at intervals of one week or one injection of 6ml Synvisc-One®. For the shoulder, hip or ankle joint we recommend three injections 2ml Synvisc® at intervals of one week each. It is important to note that an effect can only occur if the wear is not too advanced. Furthermore, the more advanced the wear, the faster the effect of the hyaluronic acid is "used up".
A new therapy is often recommended after 9 to 12 months.

According to the manufacturer, Synvisc-One® is the only "single-injection" hyaluronic acid approved by the U.S. Food and Drug Administration (FDA). It is particularly suitable for patients who are being treated with coumarins (Marcumar®) or are time-restricted. The risk of infection is reduced with a single joint puncture, but the larger volume of 6ml is sometimes experienced as uncomfortable and the feeling of pressure in the joint can last up to 3 days. Therefore, one of the two dosages is offered individually.

Alternatively, with the CINGAL® single injection therapy, an effective treatment alternative for inflammatory arthrosis is available to you, which - thanks to the combination of hyaluronic acid and cortisone - relieves arthrotic complaints quickly and for a long time and stops the degeneration process in the cartilage. The cortisone triamcinolone hexacetonide has an anti-inflammatory effect 5 times stronger than the body's own cortisol and provides rapid pain relief. The cross-linked hyaluronic acid with a high active ingredient content remains in the joint for a long time and is thus responsible for the long-term pain relief.


Hyaluronic acid is a viscoelastic fluid with specially cross-linked haluronic acid derivatives (hylans). It replaces and supplements the body's own diseased joint fluid.


Please ask your attending physician about the costs.The therapy with hyaluronic acid is not a benefit of the statutory health insurance, not of all health insurances or professional accident insurances, in individual cases the costs may be covered by the health insurances/insurances. However, these costs are often tax deductible. 

For self-payers and privately insured persons, we bill according to the scale of fees for physicians (GOÄ).

studies on hyaluronic acid

Chevalier et al.
Intra-articular Tretment with 6 ml of Hylan G-F 20 in Patients with Symptomatic Primary Osteoarthritis of the Knee: A Randomised Multi-Centre, Double-Blind, Placebo-Controlled Trial
ARD Online First March 19 2009 as 10.1136/ard.2008.094623

Conrozier et al.
Prospective, Multi-Centre, Randomised Evaluation of the Safety and efficacy of five dosing regimens of Viscosupplementation with hylan G-F 20 in patients with symptomatic tibio-femoral osteoarthritis: a pilot study
Arch Orthop Trauma Surgery D01 10.1007/s00402-008-0601-2

Hardy P. et al.
Efficacy and safety of hylan G-F 20 in shoulder osteoarthritis with an intact rotator cuff. Open-label, multi-centre study
Joint Bone Spine; Vol. 76. Issue 6, Pages 670-673, Dec. 2009

Conrozier et. al. Intra-articular injections of hylan G-F 20 in patients with symptomatic hip osteoarthritis. An Open-label, mulitcentre, pilot study Clin Exp Rheumatology; Vol. 21, Issue 5, Pages 605-610, Sept.-Oct. 2003 Witteveen et al.
A prospective multi-centre, open study of the safety and efficacy of hylan G-F 20 (Synvisc) in patients with symptomatic ankle (talo-crural) osteoarthritis
Foot Ankle Surgery; Vol. 14, Issue 3, Pages 145-152, 2008