What Are the Different Types of Hyaluronan

Hyaluronan (HA) is a naturally-occurring protein in our synovial fluid (joint fluid). There are several HA products on the market. They differ by: molecular weight, number of injections needed, and the manufacturing/production process.


There are five forms on the market right now: Synvisc, Orthovisc, Hyalgan, Supartz, and Euflexxa. All of these products utilize either avian (bird) HA/purification or an avian gene to code HA production, except Euflexxa. It appears that Euflexxa is the only completely human or non-avian product. Euflexxa is similar to the HA found in healthy knees and it is the product that we use at Reflex Clinic.




To reach a therapeutic effect, patients need a series of HA injections. The number of knee injections in the series varies between which product is being used. Most require three shots, while some are injected in a five-shot series. There is a one shot only available, but it is less effective than the three- or five-shot series.


In the past, healthcare providers often referred to HA therapy as “rooster comb” injections for knee osteoarthritis. This is because earlier versions of HA were derived from rooster combs, which contain large amounts of Hyaluronan. Today, HA injections are all manufactured in a lab-controlled biochemical process.


Euflexxa is designed to help patients who are not getting enough relief from non-prescription pain relievers or from exercise and physical therapy. When Euflexxa is injected into the knee, it helps replenish the HA in the knee and helps restore the ability of the synovial fluid to cushion, lubricate, and protect the knee.


Some people experience moderate pain relief after the first or second injection of Euflexxa, but most people experience significant relief after the third (last) injection. You can read more about our patients results on our testimonials page.

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