There are a lot of drugs for intra-articular injections on the market, and all of them, according to the manufacturers, have almost magical properties. Each of them effectively treats arthrosis - relieves pain and restores mobility. Only the effects of one of the synovial fluid prostheses for some reason disappear after six months, while the other lasts many times longer. In this article we will analyze Gialurom, Ostenil, Intraject and Noltrex according to objective criteria and comments from their developers.
Not all liquid endoprostheses are equally effective
Comparison of the characteristics of liquid endoprostheses "Hialurom", "Ostenil", "Intraject" and "Noltrex"
| "Hyalur" | "Ostenil" | "Intraject" | "Noltrex" | |
| Compound | Sodium hyaluronate 1.5%, sodium chloride, water | Sodium hyaluronate 1%, sodium chloride, sodium monohydrogenphosphate, sodium dihydrogenphosphate, water | Unstabilized hyaluronic acid 1%, water | Three-dimensional polyacrylamide 4.5%, silver ions, water |
| Molecular mass | 2,400,000 Yes | 1,000,000 Yes | 2,200,000 Yes | More than 10,000,000 Yes |
| Volume | 2 ml (also available in 3 ml dosage) | 2 ml (there is also a dosage of 1 ml for small joints) | 2 ml | 2.5 ml |
| Contraindications | Infected wounds, joint abrasions, joint infections, systemic bleeding disorders | Pronounced sensitivity to any component of the drug | Autoimmune diseases, pathological bleeding, infections and inflammation in the joint, skin damage at the injection site | Inflammation of the skin at the injection site, inflammation of the joint, period 1 week after arthroscopy |
| Side effects | Local secondary effects - redness, swelling, feeling of warmth | Local secondary effects - redness, swelling, feeling of warmth | Local phenomena - pain, redness, joint swelling, intra-articular exudation, rarely - septic arthritis | Mild to moderate burning sensation in the joint, redness and swelling of the joint - very rare |
| Possibility of allergic reactions | Rarely | Very low | Extremely rare - itching, rash, urticaria, cases of anaphylactic reactions to the drug have been reported | Very low |
| Duration of effect after course | From 6 months | 6-12 months | 6-12 months | 6-24 months |
| Number of injections per course | At least 3 | 3-5 | 3-5 | 1-4 |
| Cost for 1 package (valid for the 1st quarter of 2019) | From 5000 rub. | From 3500 rub. | From 5700 rub. | 3100 rub. |
| Cost of treatment | At least 15,000 rubles. | 10-18 thousand rubles. | From 18 thousand rubles. | From 3,100 to 12,500 rubles. |
| Does it help with late stages of osteoarthritis? | No | slightly | No | Yes |
| Manufacturer country | Romania | Germany | Russia | Russia |
Methods and frequency of administration of hyaluronic acid in the treatment of joints
Hyaluronic acid for joints is available in the form of a solution placed in a disposable syringe. The injection is given in the aseptic conditions of a treatment room or small operating room by a surgeon, neurologist or rheumatologist. The medicine is injected directly into the joint capsule.
The standard treatment regimen is one injection per week. Depending on the severity of the disease, the course includes 3–5 injections. The duration of breaks between repeated courses is different for each drug: repeated treatment, for example, with Fermatron, can be carried out within a month, a break in treatment with other drugs ranges from 6 months to a year.
Indications and contraindications for hyaluronic acid injections for joints
| Indications | Contraindications |
| Arthrosis of the joints | Hypersensitivity to the main or auxiliary components of the drug |
| Rehabilitation after arthroscopy | Wound or other violation of the integrity of the skin at the injection site |
| Recovery after traumatic joint injury | Dermatological problems of the skin over the joint |
| As an alternative to surgical treatment | Acute joint inflammation |
| Pregnancy, breastfeeding | |
| Childhood | |
| Acute period of various infections | |
| Ankylosing spondylitis, rheumatoid arthritis |
"Hyalur"
Hyalurome is a Romanian drug, a viscous sterile liquid for intra-articular injections for arthrosis and deforming osteoarthritis. The package contains a disposable glass syringe in transparent film, with a sterile needle and a protective cap. The manufacturer recommends using it for arthrosis and arthritis, as well as for osteochondrosis - for faster restoration of articular intervertebral tissue. In addition, indications include deficiency of synovial fluid, diagnostic arthroscopy and other surgical interventions on the joint.
Note!
For the treatment of arthrosis of small joints, the manufacturer recommends administering not 2, but 1 ml. "Gialurom" comes in a 2 ml package. According to the instructions, it is forbidden to use leftover medication - each syringe is intended for one injection. This means that if only one small joint is to be treated, half the contents of the syringe will not be useful.
During administration, patients report pain. Local reactions persist for 1-3 days. During this period, it is necessary to provide complete rest to the joint, and also apply cooling compresses if necessary.
After the administration of "Hyalurom" you need complete rest for up to three days.
"Ostenil"
"Ostenil" is a sterile solution of sodium hyaluronate, a highly purified biopolymer. No animal proteins are used in production, which completely eliminates allergic reactions to protein. A viscoelastic implant is indicated for degenerative and traumatic changes in the joints. It restores the lubricating, filtering and shock-absorbing properties of synovial fluid.
According to research results, the severity of pain after completing a course of Ostenil injections is reduced by an average of 55% after 3 months. The clinical effect develops after the first manipulation and persists for a period of at least six months. Is 55% enough to lead a normal lifestyle? The question is rhetorical.
Note!
The results of a study conducted by leading rheumatologists at the Institute of Rheumatology of the Russian Academy of Medical Sciences and several rheumatology centers are thought-provoking. A course of treatment with Ostenil consisting of three or five injections led to significant improvement only among 65-70% with gonarthrosis. Efficiency remained throughout the year in only 45-50% of subjects. The only good news is that the treatment did not produce serious adverse reactions, which means the drug is safe. How great its benefits are - the numbers speak for themselves.
And one more interesting point. In the instructions for the drug, the manufacturer recommends that doctors prescribe analgesics or anti-inflammatory drugs to patients during the first few days of treatment for osteoarthritis. It can be assumed that the pain syndrome after the introduction of a liquid endoprosthesis will be more noticeable than we would like.
Full course of treatment with Ostenil - 5 injections, or 5 weeks, or about 18,000 rubles
Buy Bioport synovial fluid prosthesis 1.5% 2.5ml No. 1 in pharmacies
Indications Intended for the treatment of middle stage osteoarthritis. One injection syringe contains 1.5% sodium hyaluronate.
Release form: Agent for intra-articular administration, 1.5% solution, 2.5 ml of solution per syringe - 1 pre-filled syringe in a pack. ATTENTION!!! The needle is not included. Purchased separately as prescribed by your doctor. Keep away from children Composition sodium hyaluronate 0.0375 mg/2.5 ml Description Bioport is a high-tech synthetic hyaluronic acid. Designed to restore the quantity and improve the properties of synovial fluid in joints after traumatic injuries and at different stages of osteoarthritis. The solution is sterile for a single intra-articular injection. PURPOSE Hyaluronic acid is a key component of synovial fluid. This fluid fills the joint cavity and acts as a lubricant, preventing friction of the articular surfaces. When a joint is damaged, the synthesis of synovial fluid and its quality decrease. Increased friction triggers the destruction of articular cartilage, which leads to osteoarthritis. To slow down the development of the disease, synthetic hyaluronic acid is used, which is as close in parameters as possible to the composition of human synovial fluid. How BIOPORT works BIOPORT replenishes and improves the properties of synovial fluid in cases of osteoarthritis or post-traumatic changes in the joints. The product is based on synthetic hyaluronic acid, whose molecular weight is as close as possible to the average molecular weight of the polymer synthesized by the human body. High molecular weight, that is, a large chain length of molecules, reduces friction in the joint, improves its shock absorption and mobility. With age-related changes and inflammatory processes, the length of the chain decreases, reducing the ability of hyaluronic acid to perform its main task - biological lubrication of joints. ADVANTAGES The high clinical effectiveness of the BIOPORT synovial fluid prosthesis is due to the following factors: Noticeable improvement - Hyaluronic acid retains moisture in the synovial fluid, reducing friction, improving shock absorption and increasing joint mobility. Long-lasting effect - The high molecular weight of hyaluronic acid (3-3.5 mDa) is as close as possible to the average values of the body’s natural polymer and reliably provides a long-term therapeutic effect for mild and moderate stages of arthrosis after just two injections. High-tech production - High degree of purification of the active substance - synthetic hyaluronic acid. Natural synthesis - Hyaluronic acid is produced by biofermentation (microbial synthesis), which ensures a low risk of allergic reactions and other side effects. The role of BIOPORT in the treatment of osteoarthritis The task of a synovial fluid prosthesis is to reduce friction and increase joint mobility after injuries or in the early stages of arthrosis development. Courses of therapy using BIOPORT reduce the aggressiveness of the symptoms of arthrosis and slow down the development of joint pathology over a long period (up to 12 months). At the same time, injections of hyaluronic acid do not imply the restoration of already damaged cartilage tissue and the elimination of emerging manifestations of osteoarthritis. To restore damaged cartilage tissue, other techniques should be considered, such as chondroplasty or its advanced form - matrix-induced autologous chondrogenesis. Special Conditions Synovial fluid grafts should only be inserted by trained healthcare personnel. As part of the treatment of arthrosis, this service is offered by medical institutions. It is strictly not recommended to select and administer synthetic hyaluronic acid on your own. Indications Intended for the treatment of middle stage osteoarthritis. One injection syringe contains 1.5% sodium hyaluronate. Contraindications Hypersensitivity to the components of the drug. The presence of infected wounds, abrasions, skin disease in the injection area. Like any drug, it has its contraindications, which are taken into account by the attending physician when prescribing the drug. It should not be used if you are hypersensitive to sodium hyaluronate. It is unacceptable to use the drug as an intra-articular injection for infected wounds, abrasions, or inflammation in the affected joint.
"Intraject"
“Intraject” is another liquid endoprosthesis, now made in Russia, for the treatment of moderate and moderate osteoarthritis. The manufacturer positions it as a means for the regeneration of cartilage tissue. Clinical studies have confirmed positive dynamics in the severity of pain in patients with grade 2-3 gonarthrosis, an improvement in general condition and an increase in the thickness of hyaline cartilage.
By and large, the drug "Intraject" is not much different from the previous ones, with the exception of a shorter shelf life (two years instead of three) and some other points.
The instructions indicate such a rare but dangerous complication as septic arthritis . The latter is accompanied by a local inflammatory reaction, increased body temperature and severe joint pain. Despite the fact that the manufacturer emphasizes “including those not related to the use of Intraject,” such references are still alarming and make us think that such cases have been recorded.
Another limitation specified in the instructions is incompatibility with quaternary ammonium salts, primarily benzalkonium chloride. This means that when using this drug it is prohibited to use antiseptics of this composition, which is a good idea for the patient to make sure of before administering a liquid endoprosthesis in a clinical setting.
In the instructions for Intraject we read: there have been cases of anaphylactic reactions to the drug
Effective ways
So, first of all, you need to remember an important rule: the best cosmetic product is your own arterial blood. If it circulates freely through the vessels, you will look great for a long time! But due to birth or acquired injuries (and almost all people have them), displaced bones and tense soft tissues compress the vessels and impede the outflow and circulation of blood. Hence swelling, muscle strain, wrinkles, etc. Therefore, we must do everything to relax the muscles as much as possible, relieve tension and allow blood to circulate freely through the vessels. Ideally, you need to see an osteopath. Long-term injuries are his area of work, and he knows better than anyone what to do with it. But you can do a lot yourself.
1. Neck exercises that help relieve tension and allow blood to flow freely from the face.
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- The simplest option is pinching in the shoulder and neck area. Short but noticeable pinches will improve blood circulation and swelling will decrease.
- Give your neck a good stretch. Pull your right arm down along your body, and your head to the left, then vice versa. Feel the muscles stretch. But at the same time, of course, try not to overexert yourself and do not try too hard so as not to stretch everything too much. Repeat the exercise several times. Create tension primarily through the movement of the shoulder, not the head, to avoid bending the head too far to the side. This is undesirable for blood vessels.
- Now pull your arms down and your chin up, tilting your head back slightly. When you stretch your muscles, blood also begins to circulate more freely, fluid flows better from the head and face, and swelling goes away.
- Stretching your scalp is another great way to improve circulation. Grasp your hair firmly and pull it in different directions. Do this gently, but with force, as if pulling the skin away from the skull. This exercise also helps with headaches.
2. Facial massage. Find a good professional massage therapist and take a facial massage course.
Article on the topic
You'll turn red like a tomato. Why you shouldn't make masks from vegetables and fruits 3. Choose the right pillow. Your neck should not become stiff by morning - this is the main indicator. But if you change pillows and cannot find a comfortable one, this indicates the presence of problems in the neck that arose due to previous skull injuries. And in this case, only specialized treatment can help you - you should visit an osteopath or orthopedic traumatologist.
4. The bathhouse is our friend and cosmetologist. Only a bath allows us to sweat efficiently and cleanse the skin through the pores, including the skin of the face. Ask any cosmetologist, and he will tell you that it is best to do skincare masks after a bath, since steamed skin absorbs nutrients well.
5. Sports. We are interested in aerobic exercise, which also allows a person to sweat and “wash” the pores of the face. We exclude exercises in the gym that lead to muscle overstrain with a thoughtless approach to training! Otherwise, there is a risk of only worsening your condition, or even acquiring additional health problems.
6. Washing with hot water. When taking a shower, be sure to direct the hot water stream towards your face. And in general, water is also a cosmetic product. Do not wipe your face after washing - let the water absorb into the skin. And it’s best to use mineral water - this is an improved option for washing.
7. Light self-massage in the form of a finger shower (tapping your fingers on the surface of the face) or light smoothing movements from the center of the face to the sides and up.
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8. Engage in therapy for long-standing injuries. For example, undergo osteopathic treatment. When a specialist restores the correct position of the bones and eliminates the consequences of long-standing injuries, the displaced bones stop putting pressure on the vessels and blood flows freely to and from the face.
Taking care of your beauty is not only simple, but also pleasant. Especially when you see the results.
"Noltrex"
Noltrex is another endoprosthesis, a synovial fluid substitute, made in Russia. Of all the above-mentioned drugs, it is of synthetic origin, which gives it undeniable advantages. The components of the endoprosthesis, which do not include hyaluronic acid, as in other medications, are not broken down by enzymes in the human body, so the gel remains inside the joint for a long time and provides a long-lasting effect.
It is thanks to its synthetic nature that Noltrex is a completely hypoallergenic drug and is perfectly compatible with the tissues of the human body. Another feature of it is its record molecular weight, more than 10 million Da, thanks to which it is not removed from the joint for a very long time.
"Noltrex" is an inexpensive but very effective synthetic endoprosthesis with long-lasting action
Non-invasive replacement for botulinum toxin injections
- Sculptural facial massage. Impact on facial tissues using unique proprietary techniques helps to influence deep tissues, as a result of which the condition of muscles improves, blood flow accelerates, and wrinkles are smoothed out.
- LPG massage. The hardware technique consists of a vacuum-roller effect on the facial skin. It helps improve microcirculation of blood and lymph in tissues, triggers the process of neocollagenesis and lipolysis, so swelling is reduced, the skin is tightened and smoothed. Not only facial wrinkles, but also deep wrinkles are smoothed out, muscle tone increases.
- Biorevitalization. Injections of hyaluronic acid using the preparations IAL - SYSTEM ™ and IAL - SYSTEM ACP®, Teosyal, Juvederm, Filorga, Mesowarton, Meso-Xanthin, Mesoeye replenish the lack of moisture in the skin, smooth it, and restore natural protective functions. The skin becomes softer and its elasticity is restored. In combination with other procedures, such as laser resurfacing, it helps smooth out even deep wrinkles.
- Mesotherapy. It consists of introducing special meso-cocktails into the skin and subcutaneous fat, which may include hyaluronic acid, vitamin complexes, minerals, peptides, medications and biologically active substances. Mesotherapy with peptides reduces existing wrinkles, increases skin elasticity, and restores turgor.
- 3D mesothreads. The procedure involves “stitching” the skin with special mesothreads made from the modern suture material polydioxanone. This is a biodegradable material that disintegrates over time and is excreted from the body, while the formed framework of collagen threads remains. 3D mesothreads are used to reinforce the cheek area, eliminate crow's feet, support the neck, chin, forehead and temple area. The skin is smoothed and visually becomes younger, while muscle activity is maintained.
- Contour plastic with fillers. It involves filling wrinkles and correcting areas of the face using injections of gels based on hyaluronic acid: Teosal, Juvederm, Filorga, Belotero, Radiesse. These gels are of non-animal origin, therefore they rarely cause allergies, and over time they are absorbed and excreted from the body.
A little about the price
Let's highlight:
- To keep osteoarthritis of the hip or knee under control with the help of the German drug “ Ostenil ” (costing only 3,500 rubles per injection!), you will have to fork out 10-18 thousand rubles every six months. That is, you will need from 20 to 36 thousand rubles , since the effect lasts on average only for 6-8 months.
- Treatment with Romanian “ Hyalurom ” will cost 15 thousand rubles per course - that is, about 30 thousand rubles per year .
- The Russian “ Intraject ” itself cannot be called cheap. A course of treatment with the drug costs 5,800 rubles. the injection will also cost at least 18 thousand rubles, and it will also probably have to be repeated twice a year, which means this amount is doubled - 36 thousand rubles.
- With Noltrex , which, according to some patients, costs not so little (from 3,100 rubles), you can save money. Even if the course consists of 4 injections, it will cost a little more than 12 thousand rubles . The effect will last for at least a year, meaning no additional investment is required.
Of course, it is “more prestigious” to treat arthrosis with an advanced German or popular Romanian drug. Many patients are skeptical about Russian developments, and this is still a tribute to the past. Today, some domestic medicines are not only not inferior to imported ones, but upon closer examination they even surpass them. See for yourself.
Advantages of Noltrex over the drugs Hyalurom, Ostenil and Intraject
- Due to its higher molecular weight, Noltrex lasts longer - up to two years (usually from a year to one and a half). It is impossible to get such a result from Hyalurom, Ostenil or Intraject.
- For a full course, sometimes 1-3 injections are enough, while preparations based on sodium hyaluronate must be administered at least 3 times, and in some cases 4-5.
- The cost of treating arthrosis of the knee, hip or elbow with Noltrex is significantly lower than with any other drug (about 12 thousand rubles for 4 injections, although two or three injections are often enough).
When choosing a drug for intra-articular injections, many are still guided by insignificant criteria. For some, the country of origin is a priority, for others, the cost of one injection is a priority. In fact, it is much more important to analyze the treatment regimen as a whole - with a future perspective, calculate the cost of treatment for the year, and study effectiveness statistics. The example of the comparison of popular liquid endoprostheses described above clearly shows the value of this particular approach.
