Elsevier

Pathology

Volume 33, Issue 4, 2001, Pages 519-520
Pathology

Synvisc perisynovitis

https://doi.org/10.1080/00313020120083296Get rights and content

Summary

Synvisc (hylan G-F 20) is a high molecular weight hyaluronan which is manufactured from chicken combs. It is currently one of the options used in the treatment of severe osteoarthritis of the knee joint. Synvisc is directly injected into the diseased joint, where it provides elasticity and viscosity. Published experience suggests than Synvisc is a safe and well-tolerated material with occasional mild local reactions but no long-term adverse sequelae. This article describes a case of Synvisc-related granulomatous inflammation in the perisynovial adipose tissue. To our knowledge, this is the first histological account of tissue reaction to Synvisc.

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Cited by (33)

  • Biocompatibility of cross-linked hyaluronate (Gel-200) for the treatment of knee osteoarthritis

    2014, Osteoarthritis and Cartilage
    Citation Excerpt :

    Synvisc-One was the first single injection product approved in the US and contains three times the volume of hylan G-F 20 as Synvisc, which requires three injections. However, there is growing clinical evidence to suggest that hylan G-F 20 may be associated with an increased incidence of pseudosepsis or granulomatous synovitis4–13. Furthermore, in non-clinical studies, evidence of an immune response to hylan G-F 20 has been demonstrated.

  • The Role of Viscosupplementation in the Ankle Using Hylan G-F 20

    2008, Journal of Foot and Ankle Surgery
    Citation Excerpt :

    Cases of post injection-induced pseudogout with hylan G-F 20 have also been reported (36, 43). Zardawi and Chan (44) observed granulomatous inflammation with hylan G-F 20 in the perisynovial adipose tissue and described the histological findings associated with the condition. Martens (45) described symmetrical knee inflammation after hyaluronan injection and suggested that some individuals may be uniquely susceptible to inflammatory responses.

  • A double-blind randomized controlled trial comparing alternate forms of high molecular weight hyaluronan for the treatment of osteoarthritis of the knee

    2006, Osteoarthritis and Cartilage
    Citation Excerpt :

    Several recent publications have noted acute local reactions after hylan CL-HA injection15,16, particularly in patients receiving repeat treatment17. Inflammatory reactions around hylan gel particles have also been histologically observed in synovial biopsies18,19. These reports make it especially important to consider safety differences among IA-HA products, and alternate ways of producing high molecular weight hyaluronan for viscosupplementation.

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