Table 2.

Patient eligibility for viscosupplementation with Sinovial according to the consensus findings of a systematic literature review by a Technical Expert Panel using Delphi methodology [35]

Eligibility for VS with Sinovial can be considered according to the following patient features

Patients affected by both primary and secondary OA can be candidate for VS

Patients with radiological OA KL grades I–II–III (knee or hip) are the most suitable patients for VS

Selected cases of patients with X-ray KL grade IV affected by knee OA

Patients affected by OA of the CMC with X-ray KL grades I–II–III–IV can be treated with HA

Clinical situations in which VS with Sinovial is considered appropriate:

The use of Sinovial in patients taking systemic NSAIDs is recommended to reduce the assumption of these drugs

The concomitant use of HA in patients taking SySADOAs (chondroitin sulfate, glucosamine, etc.) may improve clinical efficacy

A treatment model associating intra-articular HA to exercise and rehabilitative interventions can be useful to improve joint function

In the case of multiple joint involvement, Sinovial can be considered in different joints (at best step by step starting from the most painful joint)

The injection of Sinovial after a failure of other viscosupplements having significantly different characteristics (MW, concentration, and volume), can be given to verify if the change of product is associated with a better clinical response

CMC carpometacarpal joint, HA hyaluronic acid, KL Kellgren–Lawrence, MW molecular weight, OA osteoarthritis, SySADOAs symptomatic slow-acting drugs in osteoarthritis, VS viscosupplementation