What is Cingal?

Cingal is a revolutionary single-injection treatment that combines fast-acting corticosteroid with long-lasting hyaluronic acid (HA) for knee osteoarthritis pain relief. It’s the first and only CE mark approved hyaluronic acid and corticosteroid combination product, uniquely formulated to provide both immediate and sustained pain relief lasting up to 6 months.

The treatment combines triamcinolone hexacetonide (a powerful anti-inflammatory steroid) with high molecular weight, high concentration cross-linked hyaluronic acid. This dual-action approach targets both the inflammatory response and the mechanical wear-and-tear aspects of osteoarthritis in a single injection.

How Cingal Works

Cingal addresses the vicious cycle of osteoarthritis by targeting multiple aspects of joint deterioration:

Anti-inflammatory Action: The steroid component calms inflammation within 48 hours, which is the main cause of osteoarthritis pain. When cartilage breaks down, it releases chemicals that cause pain and swelling whilst degrading natural HA in the joint.

Long-term Joint Support: The hyaluronic acid component supplements the reduced natural HA in synovial fluid, providing lubrication, mechanical support, and stimulating the joint’s own HA production for longer-lasting relief.

Breaking the Pain Cycle: By controlling inflammation first, the steroid protects the injected HA from breaking down too quickly, allowing the HA to nourish the joint and provide sustained benefits beyond 6 months.

Clinical Evidence and Results

Cingal has been proven through rigorous clinical trials involving over 300 patients in randomised, double-blind, placebo-controlled studies:

Rapid Pain Relief:

• 59% reduction in pain at 1 week
• 89% of patients respond positively at week 1

Long-lasting Benefits:

• 72% average pain reduction at 26 weeks
• 92% of patients respond positively at 26 weeks
• Benefits often continue beyond the 6-month study period

Safety Profile: Cingal demonstrates excellent safety with only 2% adverse event rates, lower than commonly used HA injections. Side effects are typically minor and resolve naturally without treatment.

Why Cingal is Different

Single Injection Convenience: Unlike other HA treatments requiring up to 5 injections, Cingal achieves superior results with just one injection, making it more convenient for patients.

Dual-Action Formula: Combines the rapid pain relief of steroids with the long-term joint health benefits of premium HA (Monovisc), providing both immediate and sustained benefits.

Optimal HA Formulation: Contains 88mg of perfectly weighted HA that stimulates the joint’s own HA production, maximising therapeutic benefits beyond the injection’s presence in the joint.

Superior to Individual Treatments: More effective than steroid injections alone (which wear off quickly) and more rapid than HA injections alone (which can take weeks to show benefits).

Who Should Consider Cingal?

Cingal is ideal for patients with mild to moderate knee osteoarthritis who experience:

• Daily activity limitations due to knee pain
• Persistent pain and stiffness that comes and goes
• Inadequate relief from rest, exercise, or over-the-counter medications
• Pain flare-ups after physical activity
• Previous steroid injections where benefits wore off quickly

Perfect for patients who:

• Need fast relief (thanks to steroid component)
• Want longer-lasting comfort (thanks to HA component)
• Aren’t ready for surgery
• Prefer evidence-based treatments with clinical data
• Want to maintain an active lifestyle

The Treatment Process

Simple Procedure: Cingal is administered as a single injection directly into the knee joint space in a clinician’s office or physiotherapy clinic. The procedure is straightforward and can be performed by orthopaedic surgeons, rheumatologists, or qualified healthcare professionals.

Quick Results: Many patients experience pain relief almost immediately, whilst others may notice improvements within a few days. Clinical studies show statistically significant pain reduction in the first week.

Repeat Treatments: Safety of repeat injections has been confirmed through clinical studies. A second injection can be administered six months after the initial treatment as directed by your clinician.

Understanding Osteoarthritis and Why Combination Therapy Works

Osteoarthritis creates a destructive cycle where cartilage breakdown leads to inflammation, which further damages cartilage and reduces natural HA production. This compromised joint environment prevents normal cartilage repair and perpetuates pain.

Traditional approaches treat only one aspect of this cycle, but Cingal’s combination approach breaks the cycle at multiple points:

• Steroid component reduces inflammation and protects cartilage
• HA component restores joint lubrication and stimulates natural HA production
• Combined effect provides comprehensive joint protection and pain relief

The Science Behind Optimal HA

Research shows that HA must have the correct molecular weight (500,000-4,000,000 daltons) to optimally stimulate joint cells to produce their own HA. Cingal contains Monovisc, which is precisely formulated within this “Goldilocks Zone” and contains 88mg of HA – significantly more than many competitors.

This optimal formulation means the therapeutic benefits extend beyond the time the injection remains in the joint, as it stimulates the body’s natural HA production for sustained relief.

Why Choose Cingal Over Alternatives?

Compared to Steroid Injections Alone: Cingal provides the same rapid anti-inflammatory benefits but with sustained relief lasting months rather than weeks, plus joint protective effects.

Compared to HA Injections Alone: Cingal offers immediate pain relief rather than waiting weeks for benefits, whilst still providing all the long-term advantages of premium HA therapy.

Compared to Multiple Injection Protocols: Achieves superior results with one injection rather than requiring 3-5 separate appointments.

Proven Track Record: Backed by over 25 years of HA injection safety data and robust clinical trial evidence specific to the Cingal formulation.

Cingal represents a significant advancement in osteoarthritis treatment, offering patients the best of both worlds: immediate relief when they need it most, and long-term joint health benefits that help maintain an active lifestyle.

Cingal Information