Ostenil (Sodium Hyalronate 1%)
Manufacturer: TRB Chemedica
Ostenil is a new product that has been developed specifically for the treatment of osteoarthritis. It is a solution of hyaluronan (sodium hyaluronate) and is administered intra-articularly as a course of three to five weekly injections.   It can be used in the knee, or in any of the other joints in the body, such as the shoulder and hip.
Indications/Usage:
Inject into the affected joint once a week for a total of three to five injections. Several joints may be treated at the same time. Depending on the severity of the joint disease, the beneficial effects of a treatment cycle of three intra-articular injections will last at least six months. Repeat treatment cycles may be administered as required. In case of joint effusion, it is advisable to reduce the effusion by aspiration, rest, application of an ice pack and/or an intra-articular corticosteroid injection. Treatment can be started two to three days later. The beneficial effects of Ostenil develop gradually during a course of injections and persist for several months. Following a course of three to five injections, symptomatic improvement can be expected to last for up to 6 months
Side Effects:
Local secondary phenomena such as pain, feeling of heat, redness and swelling may occur in the joint treated with Ostenil. Application of an ice pack for five to ten minutes onto the treated joint will reduce the incidence of these effects. 
Precautions:
The general precautions for intra-articular injections should be observed. Ostenil should be injected accurately into the joint cavity. Avoid injections into blood vessels or surrounding tissues. As no clinical evidence is available on the use of hyaluronic acid in children, pregnant and lactating women, or in inflammatory joint diseases such as rheumatoid arthritis or Bekhterev's disease, treatment is not recommended in these cases.
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What is a synovial joint?
A synovial joint is one in which the ends of the bones are enclosed in a capsule containing a thick, slippery liquid called synovial fluid. The capsule is made of strong, fibrous tissue and is lined with a membrane called the synovial membrane. The bone ends are covered in a smooth layer of a tough, rubbery substance known as cartilage.
The synovial fluid in the joint capsule has four important functions:
it keeps the bones slightly apart, protecting their cartilage coverings from wear and tear
it absorbs shocks, again protecting the cartilage
it lubricates the joint, helping it to work freely and easily 
it acts as a filter, letting nutrients reach the cartilage, but blocking the passage of harmful cells and substances.  
The most important component of synovial fluid is a substance called hyaluronic acid. It is this substance that lets synovial fluid perform its four different functions all at the same time. Most of the joints in your body are synovial joints. Good examples, besides the knee, include the hip and the shoulder.
What happens in osteoarthritis?
The hyaluronic acid in synovial fluid does not stay there for a whole lifetime, but is continuously broken down and replaced. Normally, there is an exact balance between the breakdown of old hyaluronic acid and the production of new hyaluronic acid. In osteoarthritis, however, this balance is disturbed and breakdown happens faster than production. As a result, the synovial fluid becomes more watery and stops working properly.
Due to the change in the synovial fluid - and for other, more complex reasons - the cartilage in the joint gradually wears away. In some places, in fact, the cartilage may eventually disappear altogether.
The thinning of the synovial fluid and wearing away of the cartilage lead to the symptoms of osteoarthritis, which include pain, stiffness and swelling.
Osteoarthritis develops as people get older and is present in almost everybody over the age of 60 (although not everyone in this age group has bad symptoms). Osteoarthritis of the knee or hip may also occur in younger people, usually (but not always) because these joints have been overloaded. Possible causes of overloading include sports, jobs involving a lot of lifting and carrying, too much bodyweight and abnormal joint development.
What is Ostenil®, and how does it work?
Ostenil® is a solution containing hyaluronic acid. It is injected into the space in the joint that contains synovial fluid and works by restoring the normal balance between the breakdown and production of hyaluronic acid.

This effect of Ostenil® means that it can decrease pain and stiffness and improve the other symptoms of osteoarthritis.
The hyaluronic acid in Ostenil® is very pure and is manufactured using a process called fermentation. It contains no animal proteins, which means that it is very unlikely to cause an allergic reaction. Ostenil® has been given to thousands of patients and has not been found to cause any serious side effects. The exact make-up of the hyaluronic acid in Ostenil® has been carefully chosen so that it is as effective as possible in treating osteoarthritis.
What can I expect if I decide to have treatment with Ostenil®?
If you decide to have treatment with Ostenil®, it will be injected directly into the joint affected by osteoarthritis. This will be done once a week for 3 weeks until you have had 3 injections.*
You will probably not notice any benefits immediately after the first injection, but you should gradually start to feel less pain and stiffness over the next few weeks. The improvement in your symptoms should last for several months, depending partly on the number of injections you have. You can expect the benefit from three injections to persist for up to 9 months.
Once the effects of the first course of injections wear off, you can, if you choose, have another. After that, you can continue to have new courses of injections whenever necessary.
* In some cases your clinician may give up to 5 injections.
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英文药名: Ostenil (Sodium Hyaluronate Syringe)

中文药名: 透明质酸钠注射剂

药品简介

玻璃酸也称为透明质酸(hyaluronic acid) 是正常关节滑液重要成分之一。为了说明玻璃酸的功能, 先得从正常关节滑液的成分和功能说起。正常关节腔内含有少量关节滑液, 就象汽车轮轴的润滑油一样, 具有润滑,抗压的作用。同时还有营养支持保护关节软骨和滑膜细胞的功能。正常关节滑液包括蛋白质,玻璃酸,粘多糖,矿物质和水等。其中,玻璃酸为主要且最重要的成分之一(每毫升含2.5-3.5毫克) , 玻璃酸由正常滑膜细胞产生并分泌到关节腔内。每个玻璃酸分子平均为4-5百万道尔顿大小,在分子显微镜下就象长毛刷一样, 每个〝毛刷〞分枝上能攜帶很多水分子(大约500:1以上的水分子)。因此, 玻璃酸是润滑,抗压,支持保护关节软骨和滑膜细胞的主要成分之一.
医学研究发现: 在骨关节炎关节腔内, 由于滑膜细胞的老化, 或外伤变性, 滑膜细胞产生并分泌玻璃酸的能力显著下降。滑液中玻璃酸浓度、分子量的粘弹性均低于正常， 滑液中玻璃酸浓度每毫升少于2 毫克(含0.8-1.5毫克), 为正常的1/2到1/3;且分子量少于1百万道尔顿, 为正常的1/4到1/5，因此, 携带水分的能力显著降低(<200:1)。因而对滑膜细胞及软骨胶原纤维支架的支持和稳定作用减弱，润滑和抵抗机械力作用的生物学功能产生障碍，从而导致软骨细胞损伤。
因此,Balazs医生最早在1989 用从胚胎脐带基质提取的玻璃酸进行动物试验治疗关节炎,发现有显著疗效; 接着欧美进行大量研究发现: 玻璃酸关节内注射与其他治疗相比,能明显达到缓解疼痛，增加关节活动度的作用, 6个月为最显著。 除了提高滑液中玻璃酸钠含量，增强关节液的粘稠性和润滑功能，还可能改善滑液组织的炎症反应，促使关节内滑膜细胞生成高分子量的玻璃酸，为软骨的修复提供了高质量的原材料，有利于软骨的修复保护关节软骨，促进关节软骨的愈合与再生。为此,几年前FDA已批准玻璃酸关节内注射液用于治疗膝关节骨关节炎。现己可用于髋关节骨关节炎。
骨胶原是胶原蛋白, 而玻璃酸是透明质酸类, 并非一回事。现有供应的玻璃酸关节内注射液种类繁多: 有Ostenil, Healon, Hyalgan, hylan G-F 20,等等。唯一重要区别在于分子量: 它们从2百万到7百万道尔顿不等。 分子量小的玻璃酸(如Healon)注射到关节腔内, 容易被降解, 因而需要注射次数多(每周一次,连续5周); 而分子量大的玻璃酸(如hylan G-F 20) 不容易被降解, 因而需要注射次数少(每周一次,只要3周即可) 。
Ostenil（透明质酸钠）是一种由加拿大卫生部批准的3类医疗设备，用于治疗骨关节炎。
3个注射过程为一个疗程, 每间隔一周由膝关节注射。
经过3个注射疗程，疼痛和僵硬可得到缓解,预期持续6-12个月。
Ostenil（透明质酸钠）也可以用由于膝关节滑膜炎, 其他外伤和退行性改变引起的疼痛和行动不便等症状。

规格：透明质酸钠注射剂1% 2ml