Physician Perspective on
Synvisc-One® (hylan G-F 20)
Knee Pain Assessment
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Dr. DiNubile is an orthopaedic surgeon specializing in sports medicine. He has a private practice in Havertown, PA, and is Clinical Assistant Professor in the Department of Orthopaedic Surgery at the Hospital of the University of Pennsylvania. He has also authored the best-selling book, FrameWork: Your 7-Step Program for Healthy Muscles, Bones and Joints.
Q: What do you think about Synvisc-One?
A: I think Synvisc-One is a safe, effective treatment for osteoarthritis of the knee. Compared to other treatment options like over-the-counter medications, NSAIDs and steroid injections, Synvisc-One is a big step forward. Many of my patients are concerned about the risks of taking medications all the time. Synvisc-One may give them the ability to lessen their need for pain pills, or maybe completely avoid them. It’s a local treatment for a local condition — which makes a lot of sense. Also, the new “one shot” format makes it extremely convenient for the patient. My patients are very excited about this new option for their knees.
Q: Synvisc-One is only one injection. How does that change things for you and your patients?
A: As an orthopedic surgeon who specializes in the knee, I’m very excited about Synvisc-One. Until now, other treatments like this could be up to five injections. Logistically, that’s tough to schedule for both the doctor and patient, who may need to miss work or find someone to watch the kids several weeks in a row. Then there’s the fear of injections. Although it’s a very minor procedure, there’s still anxiety around multiple injections. So I think it’s a big plus that patients can now get this with just one visit to the doctor.
Q: How do you decide whether to give your patients a steroid injection or Synvisc-One?
A: In my mind, this has really moved steroid injections to the sidelines. I look at steroid injections as a short-term fix for flare-ups or a very inflamed knee. Or for somebody who is in severe pain and needs a very quick fix, like for an event that weekend. On the other hand, I think of Synvisc-One as the long-term strategy for really dealing with the pain and getting the patient active again.
Q: Would you treat your patients with Synvisc-One more than once?
A: Absolutely. When I talk to my patients, I explain how Synvisc-One should last for about six months. If they start to experience knee pain again, I tell them to call me to schedule another appointment. It’s possible that it could be time for another injection of Synvisc-One.
Q: Can you provide some tips for patients on how to talk with their doctor about OA and Synvisc-One? What kinds of questions should they ask?
A: I’d start out with the basics. How bad is my osteoarthritis: mild, moderate or severe? What are my treatment options? What do you recommend? Then see how the treatment progresses. If a doctor prescribes an NSAID or injects cortisone in your knee and it doesn’t work, what’s next? Am I going to need a joint replacement soon?
And if your doctor doesn’t bring up Synvisc-One or hasn’t told you if you’re a candidate, it’s well within your rights as a patient to ask about it. It helps to be armed with information. You don’t want to overwhelm a doctor with 30 questions, but do your research. Bring a brochure or an article from a web site to your appointment and discuss it with your doctor.
Sometimes just providing that thought or asking your doctor’s opinion of Synvisc-One could be the trigger that makes them say: "Yes, that’s a good option for you."
The views presented herein are solely those of Dr. DiNubile, Orthopaedic Surgeon. Genzyme Corporation does not endorse Dr. DiNubile, or his book, FrameWork Dr. DiNubile is a paid advisor for Genzyme.