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Science Behind SYNVISC® Family

SYNVISC®/Synvisc-One® is specifically designed to match the properties of healthy, young synovial fluid1-3

Physical properties of synovial fluid:

    weight (MDa)* Elasticity
(Pa at 2.5 Hz)*
(Pa at 2.5 Hz)*
    Healthy, young
synovial fluid1-3
6 117 45      
synovial fluid4-6
1.6 1.9 1.4      

Physical properties of viscosupplements:

*The clinical significance of these physical properties is unknown. No comparative conclusions regarding safety or efficacy should be derived from these data points.

†As in 21- to 45-year-old adults.

‡As in 21- to 45-year-old adults.

SYNVISC®/Synvisc-One® is designed to stay in the knee joint longer than non-crosslinked viscosupplements1-2, 24-25

Crosslinking results in longer intra-articular residence times for SYNVISC/Synvisc-One (58 and 44 days, respectively, compared with <72 hours for unmodified hyaluronic acid products).26-27,a

Crosslinking is important for HA because it provides24-25:

  • Longer intra-articular residence time
  • Higher molecular weight
  • Increased lubricating and shock-absorbing properties

aThe clinical significance of these physical properties is unknown. This information is not based on any head-to-head clinical trial. Comparisons cannot be made in absence of head-to-head clinical trials.

SYNVISC®/Synvisc-One® is the highest molecular weight HA available with a defined molecular weight1-2,7-16,18,a

ONLY SYNVISC/Synvisc-One are composed of 2 unique formulations of crosslinked polymers, a fluid and a gel.3, 27,29-31

*The clinical significance of these physical properties is unknown.

SYNVISC/Synvisc-One is derived from a natural, avian source to achieve high molecular weight (6 MDa)1,2,28

  • HA derived from bacterial production have molecular weights of 4 MDa or less28


  1. SYNVISC [prescribing information]. Cambridge, MA: Genzyme Corporation; 2014.
  2. Synvisc-One [prescribing information]. Cambridge, MA: Genzyme Corporation; 2014.
  3. Balazs EA, Watson D, Duff IF, Roseman S. Hyaluronic acid in synovial fluid. I. Molecular parameters of hyaluronic acid in normal and arthritic human fluids. Arthritis Rheum. 1967;10(4):357-376.
  4. Praest BM, Greiling H, Kock R. Assay of synovial fluid parameters: hyaluronan concentration as a potential marker for joint diseases. Clin Chim Acta. 1997;266(2):117-128.
  5. Mazzucco D, McKinley G, Scott RD, Spector M. Rheology of joint fluid in total knee arthroplasty patients. J Orthop Res. 2002;20(6):1157-1163.
  6. Watterson JR, Esdaile JM. Viscosupplementation: therapeutic mechanisms and clinical potential in osteoarthritis of the knee. J Am Acad Orthop Surg. 2000;8(5):277-284.
  7. Monovisc summary of safety and effectiveness data. Silver Spring, MD: US Food and Drug Administration; 2014.
  8. Ågerup B, Berg P, Åkermark C. Non-animal stabilized hyaluronic acid: a new formulation for the treatment of osteoarthritis. BioDrugs. 2005;19(1):23-30.
  9. Durolane [instructions for use]. Durham, NC: Bioventus LLC; 2017.
  10. Gel-One [prescribing information]. Warsaw, IN: Zimmer USA; 2011.
  11. Euflexxa [prescribing information]. Parsippany, NJ: Ferring Pharmaceuticals; 2016.
  12. Orthovisc [prescribing information]. Raynham, MA: DePuy Mitek Inc; 2005.
  13. Gelsyn-3 [prescribing information]. Pambio-Noranco, Switzerland: Institut Biochimique SA; 2016.
  14. Supartz FX [prescribing information]. Durham, NC: Bioventus LLC; 2015.
  15. Visco-3 [prescribing information]. Durham, NC: Bioventus LLC; 2016.
  16. GenVisc 850 [prescribing information]. Doylestown, PA: OrthogenRx Inc; 2015.
  17. Braithwaite GJ, Daley MJ, Toledo-Velasquez D. Rheological and molecular weight comparisons of approved hyaluronic acid products - preliminary standards for establishing class III medical device equivalence. J Biomater Sci Polym Ed. 2016;27(3):235-246.
  18. TriVisc [prescribing information]. Doylestown, PA: OrthogenRx Inc; 2017.
  19. Hyalgan [prescribing information]. Parsippany, NJ: Fidia Pharma USA Inc; 2014.
  20. Gomis A, Pawlak M, Balazs EA, Schmidt RF, Belmonte C. Effects of different molecular weight elastoviscous hyaluronan solutions on articular nociceptive afferents. Arthritis Rheum. 2004;50(1):314-326.
  21. Hymovis [prescribing information]. Parsippany, NJ: Fidia Pharma USA Inc; 2015.
  22. Smith MM, Russell AK, Schiavinato A, Little CB. A hexadecylamide derivative of hyaluronan (HYMOVIS®) has superior beneficial effects on human osteoarthritic chondrocytes and synoviocytes than unmodified hyaluronan. J Inflamm (Lond). 2013;10:26.
  23. Finelli I, Chiessi E, Galesso D, Renier D, Paradossi G. A new viscosupplement based on partially hydrophobic hyaluronic acid: a comparative study. Biorheology. 2011;48(5):263-275.
  24. Bhuanantanondh P, Grecov D, Kwok E. Rheological study of viscosupplements and synovial fluid in patients with osteoarthritis. J Med Biol Eng. 2012;32(1):12-16.
  25. Henrotin Y, Raman R, Richette P, et al. Consensus statement on viscosupplementation with hyaluronic acid for the management of osteoarthritis. Semin Arthritis Rheum. 2015;45(2):140-149.
  26. Data on file. Genzyme Corporation.
  27. Larsen NE, Dursema HD, Pollak CT, Skrabut EM. Clearance kinetics of a hylan-based viscosupplement after intra-articular and intravenous administration in animal models. J Biomed Mater Res B Appl Biomater. 2012;100(2):457-462.
  28. Boeriu CG, Springer J, Kooy FK, van den Broek LAM, Eggink G. Production methods for hyaluronan. Int J Carbohydr Chem. 2013;2013:1-14.
  29. Balazs EA, Leshchiner A, Inventors; Biomatrix, Inc, Ridgefield, NJ, assignee. Cross-linked gels of hyaluronic acid and products containing such gels. US patent 4,582,865. April 15, 1986.
  30. Balazs EA, Leshchiner A, Leshchiner A, Band P, Inventors; Biomatrix, Inc, Ridgefield, NJ, assignee. Chemically modified hyaluronic acid preparation and method of recovery thereof from animal tissues. US patent 4,713,448. December 15, 1987.
  31. Sanofi. The Making of SYNVISC [video]. 2001.

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