group has bad symptoms). Osteoarthritis of the kneeor hip may also occur in younger people, usually (butnot always) because these joints have beenoverloaded. Possible causes of overloading includesports, jobs involving a lot of lifting and carrying, toomuch bodyweight and abnormal joint development.

What is Ostenil®, and how does it work?Ostenil® is a solution containing hyaluronic acid. It isinjected into the space in the joint that containssynovial fluid and works by restoring the normalbalance between the breakdown and production ofhyaluronic acid. This effect of Ostenil® means that itcan decrease pain and stiffness and improve theother symptoms of osteoarthritis.

The hyaluronic acid in Ostenil® is very pure and ismanufactured using a process called fermentation. Itcontains no animal proteins, which means that it isvery unlikely to cause an allergic reaction. Ostenil®

has been given to thousands of patients and has notbeen found to cause any serious side effects. Theexact make-up of the hyaluronic acid in Ostenil® hasbeen carefully chosen so that it is as effective aspossible in treating osteoarthritis.

Reducing Painimproving Mobility

Reducing PainImproving MobilityWhat can I expect if I decide to

have treatment with Ostenil®?If you decide to have treatment with Ostenil®, itwill be injected directly into the joint affected byosteoarthritis. This will be done once a week for 3weeks until you have had 3 injections.*

You will probably not notice any benefits immediatelyafter the first injection, but you should gradually startto feel less pain and stiffness over the next fewweeks. The improvement in your symptoms shouldlast for several months, depending partly on thenumber of injections you have. You can expect thebenefit from three injections to persist for up to 9months.

Once the effects of the first course of injections wearoff, you can, if you choose, have another. After that,you can continue to have new courses of injectionswhenever necessary.

* In some cases your clinician may give up to 5 injections.

Patient Information9 Evolution, Lymedale Business Park, Hooters Hall Road,

Newcastle-under-Lyme, Staffordshire, ST5 9QFUnited Kingdom

Tel: 0845 330 7556 • Fax: 0845 330 7557info@trbchemedica.co.uk • www.trbchemedica.co.uk

TRB CHEMEDICA AGRichard-Reitzner-Allee 185540 Haar/München, Germany

Sodium Hyaluronate

Sodium Hyaluronate

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Ostenil® is a treatment for the symptoms

of osteoarthritis. It can be used in the

knee, or in any of the other joints in the

body that are classified as ‘synovial’. This

leaflet gives you some basic information

about synovial joints, about what

happens when you get osteoarthritis and

about Ostenil®. If you have any questions

after you have read this leaflet, please

ask your doctor.

What is a synovial joint?A synovial joint is one in which the ends of thebones are enclosed in a capsule containing a thick,slippery liquid called synovial fluid. The capsule ismade of strong, fibrous tissue and is lined with amembrane called the synovial membrane. The boneends are covered in a smooth layer of a tough,rubbery substance known as cartilage.

The synovial fluid in the joint capsule has fourimportant functions:

it keeps the bones slightly apart, protectingtheir cartilage coverings from wear and tear

it absorbs shocks, again protecting thecartilage

it lubricates the joint, helping it to work freelyand easily

it acts as a filter, letting nurtrients reach thecartilage, but blocking the passage of harmfulcells and substances.

The most important componentof synovial fluid is a substancecalled hyaluronic acid. It is thissubstance that lets synovial fluidperform its four different functionsall at the same time. Most of thejoints in your body are synovialjoints. Good examples, besidesthe knee, include the hip and theshoulder.

What happens in osteoarthritis?The hyaluronic acid in synovial fluid does not staythere for a whole lifetime, but is continuouslybroken down and replaced. Normally, there is anexact balance between the breakdown of oldhyaluronic acid and the production of newhyaluronic acid. In osteoarthritis, however, thisbalance is disturbed and breakdown happens fasterthan production. As a result, the synovial fluidbecomes more watery and stops working properly.

Due to the change in the synovial fluid – and forother, more complex reasons – the cartilage in the

joint gradually wears away. In someplaces, in fact, the cartilage may

eventually disappear altogether.The thinning of the synovial fluid

and wearing away of thecartilage lead to the symptomsof osteoarthritis, which includepain, stiffness and swelling.

Osteoarthritis develops aspeople get older and is present in

almost everybody over the age of60 (although not everyone in this age

q u e s t i o n s a n d a n s w e r s …

Knee cap (patella)

Thigh bone (femur)

Cartilage

Synovial fluid

Synovial membrane

Shin bone (tibia)

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