Joinart is a substitute for synovial fluid in joints affected by degenerative or mechanical arthropathy, which causes pain or reduced mobility.

Description
Joinart is a CE marked medical device compliant with MDD93/42/EEC directive, containing 16 mg/ml of hyaluronic acid obtained by fermentation from a high molecular weight fraction (> 1500 kDa) and not chemically modified.
Joinart is a clear, sterile, pyrogen-free, and viscoelastic solution supplied in a 2 ml syringe. Hyaluronic acid is a natural polysaccharide found in many human tissues, particularly synovial fluid, and acts in joints both as a lubricant for cartilage and ligaments and as a shock absorber. Many studies have shown that hyaluronic acid injections into joints affected by osteoarthritis restore the viscosity and elasticity of the synovial fluid, resulting in pain relief and improved joint mobility.
Joinart acts only at the level of the joint into which it is injected, without exerting any systemic action.

Composition
Main component: sterile hyaluronic acid sodium salt 1.6%. Other ingredients: sodium chloride, sodium phosphate, and water for injections.

Packaging
Joinart is supplied in a glass syringe containing 32 mg of hyaluronic acid in 2 ml of sodium chloride buffered saline solution, packaged in a blister pack.
The contents of the syringe are sterilized by moist heat.

Instructions for use
Remove any joint effusion before injecting Joinart; the same needle should be used for removing the effusion and injecting Joinart. Remove the protective cap from the syringe, taking particular care to avoid contact with the opening.
Screw the 18 to 22 gauge needle securely onto the Luer-type locking collar to ensure a leak-proof seal.
Before injection, treat the site with a suitable antiseptic solution. Inject Joinart using aseptic technique. Inject only into the joint cavity.

Administration
Joinart must be administered weekly for a total of three weeks or in any case according to the doctor's prescription.

Warnings
• The contents of the pre-filled syringe are sterile.
The syringe is packaged in a sterile blister.
The surface of the syringe is not sterile.
• Do not use Joinart after the expiry date shown on the package.
• Do not use Joinart if the package or syringe is open or damaged.
• The injection site must be on healthy skin.
• Do not inject intravascularly. Do not inject outside the joint cavity, into tissues or synovial capsules.
• Joinart has not been tested in pregnant or breastfeeding women.
• Joinart is disposable and does not need to be resterilized.
• Avoid the concomitant administration of Joinart with other products for intra-articular use in order to prevent any possible interaction.
• Do not administer Joinart in the presence of large intra-articular effusion.
• Once the package has been opened, Joinart must be used immediately and disposed of in accordance with current regulations.
• Keep out of reach of children.
• As with any invasive joint treatment, the patient is advised to avoid all strenuous physical activity for the first 2-3 days after the injection.

Contraindications
It should not be administered:
• to patients with known sensitivity to hyaluronic acid and related compounds;
• if you have an infection or skin disease near the injection site;
• if the joint is infected or severely inflamed.

Side effects
Some transient side effects may occur following the injection of Joinart, such as pain, stiffness, sensation of warmth, redness or swelling.
These side effects can be alleviated by applying ice to the treated joint. They usually disappear after a short time. If symptoms persist, consult a doctor. As with any invasive joint treatment, septic arthritis may develop if proper precautions are not observed during the injection or if the injection site is not sterile.

Storage and expiry
Joinart should be stored in its original packaging at a temperature between 0 and 25°C, away from direct sunlight and frost. The expiration date is indicated on the packaging.

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