Hyaluronan: aiding recovery after arthroscopy

Arthroscopic surgery is a highly valuable technique that brings significant benefits to thousands of patients every year. In the short term, however, it is inevitably has undesirable side-effects.

• Viscoseal acts as a temporary substitute for the synovial fluid lost during arthroscopy, performing the lubricating, shock absorbing and filtering function of this fluid.
• Viscoseal is a substitute of the lost synovial liquid after arthroscopy...
• By injecting Viscoseal after surgery the atmosphere inside the joint is reestablished. In other word, the joint function is almost the same as before it was emptied throughout the surgery.
• Viscoseal lubricates the articulation after surgery... The different effects including lubrication of the joint reduces pain after surgery.
  
• Viscoseal helps for faster and safer mobilization... The lubricating effect helps the joint to mobilize and protect it from damages.
  
• Viscoseal coats the tissue inside the joint

How does Viscoseal work?

Viscoseal acts as a temporary substitute for the synovial fluid lost during arthroscopy, performing the lubricating, shock absorbing and filtering function of this fluid. In addition, it displaces any irrigating solution left in the joint space, preventing this solution from impairing cartilage metabolism.

The introduction of Viscoseal into the joint space leads to re-establishment of the protective coating of hyaloronan over the surface of the articular cartilage and synovial membrane. By enhancing joint mobility, moreover, it may help to maintain the production of endogenous hyaluronan. Studies conducted in vitro and in vivo have shown that exogenous hyaluronan can promote wound healing and directly stimulate the synthesis of endogenous hyaluronan.

Evidence in support of Viscoseal

Clinical studies have shown that exogenous hyaluronan:

• is effective, in combination with arthroscopic surgery, in reducing pain and improving joint mobility in patients with chronic joint derangement. (Ref. 15)
  
• protect joint surface during arthroscopic surgery and facilitates such surgery. (Ref. 16)
  
• reduces pain, improves joint function and decreases levels of prostaglandins and cytokines in the synovial fluid in patients with chronic joint derangement. (Ref. 17,18)
  
• reduces pain and improves joint function in patients with degenerative and traumatic joint disorders. (Ref. 19-23)
  
• is well tolerated.

In addition, research in animals has demonstrated that exogenous hyaluronan:

• stimulates collagen remodeling and inhibits swelling of the meniscus during healing of meniscal tears. (Ref. 24)
  
• preserves proteoglycans in the lateral menisci after total medial meniscectomy. (Ref. 25)
  
• stimulates healing of damage to the anterior cruciate ligament. (Ref. 26)
  
• restores cartilage metabolism that has been disturbed by irrigation with saline solution. (Ref. 7)
  
• reduces joint pain caused by pain mediators. (Ref. 27-29)
  
• protects the articular cartilage and synovial membrane from damage following the experimental initiation of joint disease. (Ref. 30-38)

Viscoseal characteristics

• Viscoseal is isotonic solution of hyaluronan with a physiological pH value.
• It is a synovial fluid substitute indicated for the relief of pain, improvement of mobility and promotion of joint recovery following arthroscopic procedures or joint lavage.
• The concentration of hyaluronan in Viscoseal is 0.5% - similar to that in synovial fluid.
  
• The hyaluronan in Viscoseal is produced using bacterial fermentation and is highly purified. It is devoid of animal proteins and therefore has negligible allergenic potential.
  
• Viscoseal is presented in a 10 ml monodose container equipped with a luer tip and packaged in a sealed sachet. Both the container and the sachet are sterilised using moist heat.
• Viscoseal is a CE-marked medical device. (CE 0123)