What Is Durolane

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Overall, Durolane gel injections last longer than other injections, such as cortisone. For example, in a recent study, a single Durolane injection for knee or hip arthritis lasted, on average, over 400 days. But, of course, some people will have a more prolonged effect, whereas others will have a shorter effect.

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In addition, the effect of Durolane is better in younger patients with milder forms of osteoarthritis. However, even elderly patients with more severe arthritis can benefit.

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If a Durolane gel injection works, can I have a repeat injection, and is it as effective as the first injection?

We suggest a repeat injection no earlier than six months from your last injection. Studies indicate repeat injections are just as effective as the first injection for up to five repeat injections.

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Durolane injection side effects

Like any injection, Durolane is not without side effects and risks. However, adverse effects were not increased compared to ‘placebo’ injections (using sterile water). Generally, most side effects are mild and will go away without the need for medical attention. Overall, adverse effects include:

Common side effects

Some of the more common side effects of Durolane include:

Mild joint swelling lasting for up to a few weeks

Joint pain, which settles after about a week

Muscle stiffness around a joint

Rare but severe side effects

See a doctor if you suffer from any of the following side effects:

Severe joint swelling suggests an allergic reaction, sometimes called ‘pseudosepsis’. Often, a doctor must drain the knee and test it to rule out infection. This particular reaction rarely occurs. We also think the reaction rate is less if done with ultrasound image guidance.

Severe swelling, pain, and intense heat or warmth from the joint suggest an infection. Also, you may feel unwell with generalised aching, fevers, and sweats. This reaction is about 1-10000 to 1-100000.

I‘ve heard reports of severe pain after a Durolane gel injection. Are these reports accurate?

Yes. There have been case reports of severe reactions after Durolane injections. Mild reactions to hyaluronic acid are reasonably common (10-20%) and last 1-2 weeks. However, some patients have a severe reaction called ‘psuedosepsis’ (1:100). We don’t know why these severe reactions occur, but they can arise with any hyaluronic acid, not just Durolane. Also, we think these reactions occur more frequently if a hyaluronic acid injection is performed without imaging guidance. So, while you need to be aware that these reactions happen, they are rare and are less likely with imaging guidance.

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Other frequently asked questions about Durolane:

Is Durolane a steroid?

Does the molecular weight of hyaluronic acid matter?

Generally, molecular weight refers to how heavy the hyaluronic acid molecules are. Viscosupplementation can be high molecular or low molecular weight. High molecular weight only needs one injection.

There is some debate about whether high or low molecular weight is better. However, recent evidence suggests that high molecular weight hyaluronic acid is better. In one study, the effect of high molecular weight was at least double the low molecular weight. In addition, the Arthroscopy Association of Canada suggests that high molecular weight hyaluronic acid demonstrates a better effect on knee and hip arthritis pain.

Also, low molecular weight hyaluronic acid needs more than one injection (often up to five). For example, a study comparing one injection of Durolane with five injections of a low molecular weight hyaluronic acid showed no difference in effect.

Durolane injection UK vs Synvisc: which is better?

Both Durolane and Synvisc are high molecular weight hyaluronic acids. However, Synvisc is made from egg protein. We think egg protein increases the risk of adverse reactions such as allergies.

Also, a recent study examined a head-to-head comparison of these two brands for treating knee arthritis. The scientists found that only Durolane positively affected pain six months after the injection, whereas Synvisc only had an impact at three months but not six months.

Durolane injection UK vs PRP (platelet-rich plasma): which is better?

There have been no head-to-head comparisons between these two injections. However, a recent study found that a high molecular weight hyaluronic acid such as Durolane had the same effect as PRP. Also, this positive effect seems more consistent with Durolane but is more variable in PRP. In addition, Durolane is only one injection, whereas PRP requires up to three injections.

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Can you have Durolane injection UK together with PRP?

Yes. Recent evidence suggests combining hyaluronic acid with a PRP is better than either. Combining two improves outcomes at 3, 6, and 12 months compared to PRP alone.

Is an ultrasound-guided Durolane injection better?

Yes. Using ultrasound guidance means that the injeciton is more accurate and effective.

A recent study showed that a hyaluronic acid injection performed with ultrasound has a much better effect than blind injections (without ultrasound). In a survey with over 1000 patients who had hyaluronic acid injections for knee arthritis, ultrasound injections had much fewer rates of knee replacement (over 30% less) than those who had blind injections. Moreover, ultrasound-guided hyaluronic acid injections were 27% less likely to need a subsequent cortisone injection for pain.

Also, we think using ultrasound reduces the risk of a severe allergic reaction.

You should ensure your doctor uses ultrasound to administer a knee gel injection.

Can you walk after a Durolane injection?

Yes, but you should limit your walking for a few days after a Durolane injection. We suggest you avoid sports activity for at least a week after the activity. This blog outlines activity after a knee gel injection.

How many Durolane injections can you have?

Unlike cortisone, Duroalne is not harmful to joints. Moreover, there is evidence that Durolane may protect knee joints. Recent studies suggest that Duroalne injections can delay the progression to joint replacement.

There are no limits on the number of Duroalne injections. However, the time between injections should not be less than six months.

Final word from sportdoctorlondon about Durolane injection UK

Durolane is one injection of hyaluronic acid that is effective for joint arthritis. Generally, it is our preferred first injection option for knee arthritis unless you’ve had a reaction to Durolane in the past.

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If a Durolane gel injection works, can I have a repeat injection, and is it as effective as the first injection?