doctor injecting patient's knee

The treatment of knee osteoarthritis with intra-articular hyaluronan injections is becoming increasingly popular, which is why there are several brands of these medications out there.  As the title suggests, we will focus on Orthovisc and Euflexxa this time.

There are some significant similarities between Orthovisc and Euflexxa, making it difficult to choose between them. In this Orthovisc vs. Euflexxa showdown, we will take a closer look at both of these injectable medications, so you can make an informed decision about which one is best for your patients.

What are Orthovisc and Euflexxa?

Orthovisc and Euflexxa are two of the five FDA-approved hyaluronic viscosupplements used in treating knee osteoarthritis. Viscosupplementation is a minimally invasive treatment that is prescribed when other options, including exercise, physical therapy, and oral medication, aren’t applicable. This procedure involves injecting synthetic hyaluronic acid into the knee.

Knee osteoarthritis is quite common, as some statistics suggest that, among the population that is 60 years old and older, 10% of men and 13% of women are affected. It’s considered one of the major causes of disability within this age group. However, younger generations aren’t spared either. The most common reason they may develop knee OA is a knee injury.

The way both Orthovisc and Euflexxa work when treating this debilitating condition is by supplementing the hyaluronic acid that is naturally found in the synovial fluid of the knee between the joints. This helps lubricate the joints so that the bones don’t rub together. These injections won’t repair the damaged cartilage, but they help ease the pain.

Key Similarities and Differences

A comparative study conducted by Nicholls et al. (2018) concluded that the properties of Orthovisc and Euflexxa reflect that of a healthy knee the most out of the five FDA-approved hyaluronic acid knee injections. More precisely, their average molecular weight most closely matches the synovial fluid found in healthy knees.

However, one difference between Orthovisc and Euflexxa is that the latter has a slightly higher average molecular weight, closer to what is considered the ideal weight.

Furthermore, they both contain highly purified hyaluronan that is non-avian. Namely, hyaluronic acid used to be produced from rooster comb, and some brands still apply that approach. However, Euflexxa and Orthovisc’s hyaluronan is made from a substance extracted from bacterial cells.

These injectable medications are intra-articular, which means they are administered between the joints. This is done strictly by a medical professional who is qualified to perform this kind of treatment.

In the case of Euflexxa, the patients receive three weekly injections. Similarly, those who are being given Orthovisc will have the procedure repeated once a week, three to four times in total.

Benefits of Orthovisc and Euflexxa

Orthovisc can be beneficial in providing pain relief for those who are experiencing knee OA. You should keep in mind that the Orthovisc injection doesn’t actually cure the condition, but the positive effects can last for up to six months.

These are also the benefits of Euflexxa injections. Generally, all hyaluronans have a reasonably significant success rate, but it has been discovered that a number of factors may affect the outcome. This includes the patient’s age, weight, and how severe the osteoarthritis is.  

Another advantage of both Orthovisc and Euflexxa is that they have anti-inflammatory effects. These injections are also chondroprotective and may slow down the progression of knee osteoarthritis.  

Potential Side Effects and Disadvantages of Orthovisc and Euflexxa

As with any medication, there are potential adverse reactions to Orthovisc and Euflexxa. When it comes to Orthovisc, patients may experience some common side effects after injection, including:

  • swelling, pain, redness, warmth, bruising, or itching in the proximity of the injection site
  • joint stiffness
  • headache
  • dizziness
  • back pain

There is also a slight possibility of more severe side effects occurring. These are extremely rare, but you should be aware of them. The list includes:

  •  bleeding
  •  infection
  •  worsened knee pain

The disadvantages of Euflexxa don’t differ much from those of Orthovisc. Typical side effects you may also encounter when being treated with Euflexxa are some swelling, pain, redness, warmth, bruising, or itching around the area where the injection is administered.

Although quite common, these adverse reactions should wear off quite quickly. The same goes for joint stiffness, headache, dizziness, and back pain. Euflexxa may also cause temporary fatigue, tenderness, and higher blood pressure. More severe complications similar to those induced by Orthovisc may also occur in rare circumstances.


Both Orthovisc and Euflexxa are FDA-approved high molecular weight hyaluronans that may be your patients’ ticket to a pain-free life.  Regardless of whether you opt for Orthovisc or Euflexxa, they will provide your patients with significant pain relief without having to resort to knee surgery. 


Does Orthovisc really work?

Yes, Orthovisc can help ease the pain caused by knee osteoarthritis, and due to its molecular weight, it’s among the most beneficial knee injectables. This pain relief can last up to six months. The success rate of Orthovisc and other hyaluronic acid injections depends on a series of factors, including age, weight, and the severity of OA.

How good is Euflexxa?

Euflexxa can be very beneficial when it comes to pain relief, but unfortunately, as is the case with all of these injectable knee medications, it doesn’t work for everyone. However, it is one of the best options on the market, and many have found it helpful. 54% of 253 users who rated the medication have reported positive effects, which proves its effectiveness,

Is Euflexxa better than Orthovisc?

Since the hyaluronan injections are supposed to supplement the hyaluronic acid found in the synovial fluid of the knee, choosing the injectable with the average molecular weight that is the most similar to that of a healthy knee may be the best approach. This property makes Euflexxa and Orthovisc the top two choices. In terms of comparing Orthovisc vs. Euflexxa, Euflexxa has a slight edge due to its better molecular weight.


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