Comparison of Monovisc, Durolane, Synvisc, and Neovisc in the Management of Joint Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disorder that involves the breakdown and eventual loss of cartilage. As the condition progresses, patients often experience pain, stiffness, and decreased mobility. One of the commonly used treatments for OA is the intra-articular injection of hyaluronic acid (HA) preparations, including Monovisc, Durolane, Synvisc, and Neovisc. This article aims to compare these four agents based on their efficacy, duration of relief, and safety.


  1. Monovisc

– Composition: Monovisc is a high molecular weight, non-crosslinked hyaluronic acid.

– Efficacy: Monovisc has been shown to provide significant pain relief and functional improvement in patients with OA, especially those with knee osteoarthritis.

– Duration: The pain relief from Monovisc can last up to six months.

– Safety: Adverse reactions include injection site pain, swelling, or redness. However, these reactions are usually mild and temporary.


  1. Durolane

– Composition: Durolane is a single injection, non-animal stabilized hyaluronic acid (NASHA).

– Efficacy: Studies have shown that Durolane can reduce pain and improve joint function in OA patients.

– Duration: The relief provided by Durolane can last up to six months.

– Safety: Like Monovisc, Durolane can cause mild side effects like pain or swelling at the injection site.


  1. Synvisc

– Composition: Synvisc is made up of hylan polymers derived from chicken combs. It is available in Synvisc and Synvisc-One formulations.

– Efficacy: Clinical trials have demonstrated the efficacy of Synvisc in reducing pain and improving function in knee OA patients.

– Duration: Synvisc requires three injections spaced a week apart, while Synvisc-One is a single injection. Both can provide relief for up to six months.

– Safety: Potential side effects are similar to the other preparations but may also include local allergic reactions.


  1. Neovisc

– Composition: Neovisc is a non-crosslinked, high molecular weight hyaluronic acid.

– Efficacy: Neovisc has been found to be effective in reducing pain and increasing joint mobility in OA patients.

– Duration: Its pain-relieving effects can also last up to six months.

– Safety: Neovisc is generally well-tolerated with potential side effects similar to the other mentioned agents.



Monovisc, Durolane, Synvisc, and Neovisc all play a pivotal role in the management of joint osteoarthritis. They all aim to restore the viscoelastic properties of the synovial fluid, providing lubrication and shock absorption. While all these agents have demonstrated efficacy in reducing pain and improving function, the choice of agent should be tailored to the individual patient’s needs and the clinician’s experience. It is also essential for patients to consult their healthcare providers regarding the best suitable treatment for their condition.