Two Single-Injection Powerhouses
When choosing between single-injection HA treatments, Synvisc-One and Monovisc are both excellent avian-derived options. Both deliver the full treatment in one office visit—but they come from different pharmaceutical giants with different formulations.
Side-by-Side Comparison
| Factor | Synvisc-One | Monovisc |
|---|---|---|
| Manufacturer | Sanofi | DePuy Synthes (J&J) |
| Injections needed | 1 | 1 |
| Volume | 6 mL | 4 mL |
| Molecular weight | Very high (6M Da) | High (1-2.9M Da) |
| Source | Avian | Avian |
| Cross-linked | Yes | Yes |
| FDA approval | 2009 | 2012 |
| Duration of relief | Up to 6 months | Up to 6 months |
| Self-pay cost | $800-$1,200 | $700-$1,100 |
Synvisc-One: The First Single-Shot
What It Is
Synvisc-One was the first single-injection HA product to reach the US market. Made by Sanofi (a global pharmaceutical leader), it contains hylan G-F 20—the same formula as the original three-injection Synvisc, but in one concentrated dose.
Key Advantages
Considerations
Monovisc: The J&J Contender
What It Is
Monovisc comes from DePuy Synthes, Johnson & Johnson’s orthopedic division—the same company that makes joint replacements. It’s essentially a single-injection version of their established Orthovisc product.
Key Advantages
Considerations
The Molecular Weight Question
Does higher molecular weight mean better results? Here’s what we know:
| Theory | Evidence |
|---|---|
| Higher MW = more cushioning | Logical, but not proven in trials |
| Higher MW = longer duration | Not consistently demonstrated |
| Both are “high” MW | True—both exceed natural synovial fluid |
Clinical reality: Head-to-head studies haven’t shown meaningful differences in patient outcomes between different molecular weight products. Both Synvisc-One and Monovisc provide effective relief.
Allergy Considerations
Both Require Allergy Screening
Neither Synvisc-One nor Monovisc is safe for patients with:
- Egg allergies
- Chicken allergies
- Feather allergies
- Any poultry sensitivity
If you have avian allergies, consider Durolane (single-injection, non-avian) or Euflexxa (three-injection, non-avian).
Cost and Insurance
| Factor | Synvisc-One | Monovisc |
|---|---|---|
| Self-pay | $800-$1,200 | $700-$1,100 |
| Medicare typical | $100-$350 | $100-$300 |
| Insurance preference | Varies | Varies |
Pro tip: Some insurance plans have contracts that favor one product over the other. Ask your provider which is preferred by your specific plan to minimize out-of-pocket costs.
Making Your Decision
Lean toward Synvisc-One if:
- You want the highest molecular weight available
- You prefer the most established single-injection option
- Your provider has extensive Synvisc experience
- Your insurance covers it equally
Lean toward Monovisc if:
- Cost is a significant factor
- You prefer smaller injection volume
- Your insurance prefers J&J products
- You’ve used Orthovisc successfully before
Questions for Your Doctor
- Which product does my insurance prefer?
- What’s your experience with each product?
- Have you noticed any differences in patient outcomes?
- Which has better availability in your office?
- Given my specific situation, which would you recommend?
The Bottom Line
Both Are Solid Choices
Synvisc-One and Monovisc are both proven single-injection treatments from major pharmaceutical companies. The differences are subtle:
- Synvisc-One: Higher molecular weight, more clinical data, slightly higher cost
- Monovisc: Smaller volume, often lower cost, J&J orthopedic expertise
For most patients, either will work well. Let insurance coverage, provider preference, and cost guide your decision.
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Questions? Browse our guides:
How to Choose a ProviderRelated Resources
- Synvisc-One Complete Guide
- Monovisc Complete Guide
- Single vs. Multi-Injection: Which Is Better?
- Medicare Coverage for Knee Injections
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