Durolane (hyaluronic acid) is an injectable medication primarily used to alleviate the swelling, stiffness, and pain associated with osteoarthritis, particularly in the knees and hips. The medication is also sometimes used in cosmetic surgery, though this use is off-label in many areas.

Durolane should not be administered to patients below age 18; effects on young bodies are unknown.

Durolane Basics

This product is quite effective for the majority of patients who use it. Strikingly similar to the natural fluid found around joints---which lubricate and cushion joints---Durolane can replace the natural fluid, restoring effectiveness, and a single injection can last up to six months. They're so effective that Durolane injections are sometimes used to delay knee or hip replacement surgery for months or years.

In osteoarthritis the natural joint fluid begins to degrade, breaking down and becoming thinner. This leads to inflammation, stiffness, pain, and other associated symptoms. Prior to using Durolane the natural fluid should be removed, usually immediately before---even using the same syringe needle---administering Durolane.

The first administration of Durolane is ideally done in a healthcare setting, where a healthcare worker can demonstrate the correct procedure. Patients will likely also be given the option to purchase the correct sized syringes, needles, local anesthetic, and other needed supplies.

Each vial of Durolane is designed to be attached and de-attached to the syringe needle. This is so once inserted into the target area to remove natural joint fluid the needle does not need to be removed; the vial containing natural joint fluid can be de-attached and the vial containing Durolane can be attached. This is not just to reduce pain; it ensures the injection site is correct.

Administration

The exact dosage of Durolane depends on what area is being treated; for the knees and hips 3ml is standard; for smaller joints, less is required. In all cases prior to attempting to administer this medication at home patients should seek doctor advice and, ideally, have the first injection administered in a healthcare setting.

General treatment guidelines are:

• Prepare the injection site by swabbing it with an antiseptic solution.
• Administer topical or local anesthetic, if desired.
• Insert the syringe needle into the joint. The correct location and method should have been demonstrated in a medical setting.
• If present, any joint effusion should be removed. This also ensures needle location is correct.
• Leaving the needle inserted, remove the vial containing joint effusion and apply the vial containing Durolane.
• Inject the Durolane. For knees and hips the standard dose is 3 ml, though this may vary with doctor advice. For smaller joints less of the medication will be needed.
• Avoid strenuous activity or weight-bearing activities for at least 48 hours following an injection. A doctor may advise even longer.
• Treatment can be repeated, if needed, at 6 months, or sooner if a doctor advises so.

Some patients experience a degree of pain even if local anesthetics are used. In most cases the pain is not severe, and should be completely gone within 48 hours provided weight-bearing and strenuous activities are avoided.

Osteoarthritis and the procedure for administering Durolane are both relatively complex, more so than the scope of this article can fully explain. All patients should read the information that comes with Durolane and speak to a doctor about use and administration. Do not be afraid to ask the doctor any questions, or bring any concerns to a doctor's attention, no matter how trivial they may seem.

Adverse Reactions

Patients who are allergic to birds or egg products should speak with a doctor about potential risks prior to administration; these patients are at increased risk of being hypersensitive to Durolane.

Side effects are rare, and most of them occur shortly after the injection is administered. These should fade away in the next day or two. Relatively common are:

• Redness, stiffness, or other irritation around injection site
• Runny or stuffy nose, sore throat, or other cold-like symptoms
• Mild nausea or stomach discomfort
• Headache
• Dizziness
• Tingly feeling
• Swelling in hands or feet
• Difficulty walking

The above are generally not cause for concern unless severe enough to be disruptive or persistent past the first few days; if they are disruptive or persistent, a doctor should be consulted.

Patients with an active infection in or near the injection site should speak with a doctor prior to use. If unable to speak with a doctor, do not inject Durolane until the infection is resolved.

Effects of this product on unborn or nursing babies are unclear; in general, treatment should be avoided by pregnant or breastfeeding mothers.