Hylan G-F 20 (Synvisc® and Synvisc-One®): A Comprehensive Clinical and Pharmacological Review for the Management of Knee Osteoarthritis

Introduction and Product Profile

Overview of Hylan G-F 20 as a Viscosupplementation Agent

Hylan G-F 20 is a high-molecular-weight, elastoviscous fluid classified as a viscosupplementation agent.[1] It is a sterile, nonpyrogenic, cross-linked derivative of hyaluronan, a naturally occurring glycosaminoglycan that is a critical component of healthy synovial fluid.[3] The primary therapeutic application of Hylan G-F 20 is the treatment of pain associated with osteoarthritis (OA) of the knee.[1] Its place in therapy is specifically for patients who have failed to achieve an adequate response to conservative nonpharmacologic interventions, such as exercise and physical therapy, as well as simple oral analgesics like acetaminophen.[1]

The underlying principle of its use, known as viscosupplementation, is to restore the rheological and physiological properties of the synovial fluid within an osteoarthritic joint.[16] In OA, the endogenous hyaluronan within the synovial fluid becomes depolymerized, leading to a decrease in its molecular weight and concentration. This degradation impairs the fluid's elastoviscous properties, compromising its ability to function as a lubricant and shock absorber, thereby contributing to pain and progressive joint damage.[16] By introducing an exogenous, high-viscosity hyaluronan derivative, Hylan G-F 20 aims to mechanically supplement the pathologic synovial fluid, reduce pain, and improve joint function.[1]

Commercial Formulations: Synvisc® and Synvisc-One®

Hylan G-F 20 is commercially available in two distinct formulations, which share the same active material but differ in their administration protocol: