Hyruan ONE is a cross-linked, single injection and formulated as high molecular weight (10 Million Dalton*) indicated for the treatment of OA of knee, shoulder, ankle and hip.
With this unique combination, Hyruan ONE offers double mode of action with just ONE injection. First, it provides mechanical protection to the joint, shock absorbing effect and lubrication. Secondly, it provides biological effects such as anti-inflammatory, pain relief and protection to the cartilage surface up to six months** as well as replacing diseased synovial fluid and to restore the visco-elasticity loss in the knee joint caused by osteoarthritis (OA)
*Molecular weight of synovial fluid of young and healthy adults is between 6-10 Million Dalton.
**Pain relief duration may vary across patient to patient depending on the severity of knee OA stages. ?
2What is Hyaluronic Acid (HA) and why is HA important in OA ?
Hyaluronic Acid (HA) is a molecule found naturally throughout the human body especially the joint fluid called synovial fluid. However, the HA in your synovial fluid is continuously broken down and replaced over time. During a progression of OA, the HA is broken down faster than it should be regenerating in the synovial fluid.
HA is an important component of the synovial fluid. The synovial fluid enables joints to move easily and freely while providing shock absorption in the joint during physical activity. In a healthy joint, the synovial fluid helps to protect bones and other joint tissues from injury and disease. The synovial fluid also supplies oxygen and nutrients and removes carbon dioxide and metabolic wastes from the cartilage cells in the surrounding cartilage.
3Who is eligible for Hyruan ONE or when should I consider HA injection ?
If you have knee osteoarthritis pain and the pain is not controlled by lifestyle changes, exercise and physical therapy or simple oral painkillers, you could be a candidate for Hyruan ONE treatment.
To find out if Hyruan ONE might be right for you, please consult your doctor.
4Can HA treatment postpone joint replacement surgery?
One of the more recent study* shows patients who received 5 or more courses of hyaluronic acid treatment delayed their knee replacement operation by an average of 3.6 years. However, patients without hyaluronic acid treatment had their knee replacement surgery after an average of 9 months.
5How do I know if I have osteoarthritis in my knee?
You may have knee osteoarthritis if you experience one or more of the following common signs and symptoms:
- Increase pain in the knee during activity, but gets a little better with rest
- Swelling or tenderness around the knee
- Feeling of warmth in the joint
- Stiffness in the knee, especially in the morning or when you have been sitting for a while
- Decrease in mobility of the knee, making it difficult to get in and out of chairs or cars, using the stairs, or walking
- Creaking, crackly or popping sound that is heard when the knee moves
For proper diagnosis and treatment, we strongly advise you to consult an orthopaedic specialist for further examination. Clinical examination and X-rays will help the doctor to make a diagnosis for OA.
If you have joint pain or stiffness that doesn’t go away, make an appointment with your doctor.
6How is Hyruan ONE given? / Does Hyruan ONE treatment involve any other drugs or surgery?
Hyruan ONE is a single injection treatment, usually called viscosupplementation injected directly into the knee by a certified doctor, usually a specialist, an orthopedic surgeon or a rheumatologist.
Hyruan ONE treatment does not involve any additional surgery or drugs (other than local anaesthesia, a topical spray or an injection under the skin to numb the knee area may be considered by the doctor).
7What to expect on procedure day? / How is the treatment performed?
The injection procedure will take up to 5-10minutes.
First, the doctor will disinfect the knee area, using povidone which is a brownish-yellow solution, this process will take about 1-2 minutes.
The doctor will further clean the area with alcohol solution. Next, a small dose of local anaesthesia such as lignocaine to numb the knee area before the Hyruan ONE injection, so that you won’t feel any sensation and within the next 5-10 seconds, Hyruan ONE is injected and the whole procedure is done!
8Will the injection hurt? / Are hyaluronic acid injections painful?
Like any other injection, patient might feel little pain or discomfort during the injection. However, some doctors might apply a topical drug to numb the skin or inject a small dose of local anesthesia such as lignocaine prior to giving the Hyruan ONE injection, which helps to minimize any pain or discomfort during the HA injection.
9How is Hyruan ONE different than steroid injection?
A steroid injection is generally a powerful anti-inflammatory drug to reduce inflammation and provide immediate pain relief. Steroid injection is usually considered if the joint is having acute pain and inflammation. It usually works faster than a hyaluronic acid injection, however, the pain relief doesn’t last as long and has it’s disadvantages such as making your cartilage wear off faster and making your bone porous.
Studies have shown that steroid injections provide pain relief up to a few weeks and could not be repeated for more than 3 times a year. However, Hyruan ONE injection can last for 6-12 months* and it is safer for repeat dose when needed.
10 What happens after the injection?
You are advised to rest, reduce movements and refrain from sports activities from Day 1 to 3 after the injection. You will receive a gel pack in your post injection care kit. Apply the refrigerated gel pack at the treated area for 3 times a day, each time 15 – 20 minutes for the first 3 days post injection. During this period, normal walking, standing and non-strenuous activities to the treated joint are allowed.
At Day 4 and onwards, you may start some light exercises and physio-exercise for the treated area such as your knee joints. Exercises such as stationary cycling and brisk walking on flat surfaces are highly recommended.
11Are there side effects? / What are the side effects of Hyruan ONE?
The common but temporary side effects reported are redness, warmth, swelling and injection site pain.
However, these side effects will normally go away after 24 - 48 hours post-treatment.
If the side effects persist for more than 7 days, please consult your doctor for further examination.
12How long does Hyruan ONE last? / How long will I experience knee pain relief? / How long does it take for HA injections to work? / When will I start to feel pain relief?
You may start to feel the pain reduction 2-3 weeks after the treatment and the greatest pain reduction can be felt after week 10 to week 14*.
However, pain relief duration may vary across patient to patient depending on the severity of knee OA stages.
Reports shows for mild to moderate stage, patient may experience pain relief up to 6 months while some other patients may experience continuous pain relief beyond 6 months.
*Ha et al. BMC Musculoskeletal Disorders (2017) 18:223
13Can I receive Hyruan ONE treatment more than once? / Are repeat treatments with Hyruan ONE safe?
Yes, you can receive Hyruan ONE treatment more than once. Hyruan ONE can be repeated safely.
It can be done as frequent as 3 months, depending on how long the pain relief last for each individuals.
14What are the factors that will affect the treatment outcome?
The treatment outcome can be different by the severity of knee OA, daily activities and lifestyles of each individual patient.
15Will there be a reason why I could not get a Hyruan ONE treatment?
In principle, there are no known restrictions in receiving Hyruan ONE injection to treat knee OA pain.
However, the treatment should you receive it will be decided between you and your consulting doctor.
We advise you to inform your doctor should you have:
i. Allergic reaction to hyaluronate products.
ii. Infection or skin condition present at injection site.
16How is one injection enough, when other HA preparations need 3 to 5 injections per treatment cycle?
Hyruan ONE is an improved formula single injection. It has a longer pharmacological effect even with a single administration. Hyruan ONE is the 3rd generation of the Hyruan family of HA injections made by LG Chem.
17Does insurance cover Hyruan ONE injections ?
Once Hyruan ONE procedure is confirmed by your doctor upon the diagnosis of knee osteoarthritis, you may apply for insurance coverage through the hospital.
The approval of the insurance coverage is subjective to the policy of your insurance company as applied.