9 Evolution, Lymedale Business Park, Hooters Hall Road,Newcastle-under-Lyme, Staffordshire, ST5 9QF

United KingdomTel: 0845 330 7556 • Fax: 0845 330 7557

info@trbchemedica.co.uk • ostenil.trbchemedica.co.uk

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

What is Ostenil® Plus, and how does it work?

What can I expect if I decide tohave treatment with Ostenil® Plus?

Patient Information

Sodium Hyaluronate 2% + Mannitol

age group has bad symptoms). Osteoarthritis of theknee or hip may also occur in younger people,usually (but not always) because these joints havebeen overloaded. Possible causes of overloadinginclude sports, jobs involving a lot of lifting andcarrying, too much bodyweight and abnormal jointdevelopment.

What is Ostenil® Plus, and how does it work?Ostenil® Plus is a solution containing hyaluronic acid.It is injected 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® Plus meansthat it can decrease pain and stiffness and improvethe other symptoms of osteoarthritis.

The hyaluronic acid in Ostenil® Plus is very pure andis manufactured using a process called fermentation.It contains no animal proteins, which means it is veryunlikely to cause an allergic reaction. The addition ofMannitol (a simple sugar derivative) to Ostenil® Plusallows the Hyaluronic Acid to work for longer andmore efficiently in the joint, enabling effectivesymptom reduction with a single injection. Ostenil® Plus has been extensively tested, and hasnot been found to cause any serious side effects.

The exact make-up of the hyaluronic acid in Ostenil® Plus has been carefully chosen so that it is aseffective as possible in treating osteoarthritis.

What can I expect if I decide tohave treatment with Ostenil® Plus?If you decide to have treatment with Ostenil® Plus,it will be injected directly into the joint affected byosteoarthritis.*

You may not notice any benefit immediately afteryour injection, but will gradually experience areduction in pain and stiffness. The improvement inyour symptoms is likely to persist for several months,depending on the progression of the degenerativechange in the joint being treated.

When the effects of your Ostenil® Plus injectionbegin to wear off, you can safely choose to haveanother injection if your clinician agrees it isappropriate. Thereafter, you can continue withOstenil® Plus therapy whenever necessary. * In some cases your clinician may give more than one injection.

Sodium Hyaluronate 2% + Mannitol

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 • ostenil.trbchemedica.co.uk

89723 Ostenil Leaflet_89723 Ostenil Leaflet 01/03/2016 12:53 Page 1

Knee cap (patella)

Thigh bone (femur)

Cartilage

Synovial fluid

Synovial membrane

Shin bone (tibia)

Ostenil® Plus 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® Plus.

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

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