ONE STEP FORWARDPut knee pain behind you.

Your knee joint is lubricated by synovial fluid, which contains hyaluronic acid and acts as the knee’s shock absorber.

With OA of the knee, HA in the synovial fluid breaks down and doesn’t work as well to lubricate the joint. Over time, increased friction between the cartilage surfaces causes them to wear away. This is thought to become painful and to cause irritation and inflammation that may increase pain and lead to swelling and stiffness.

Several things are thought to contribute to the development of OA of the knee, such as:

• Excessive wear and tear on the knee joint

• Aging

• Heredity

• Traumatic injury

• Weight gain

• Repetitive stress injuries

Women of age 50 and over are more likely to develop OA of the knee, however, it can affect both men and women much earlier in life. You may find yourself with limited movement and having to modify your activities to avoid or reduce your knee pain.

WHAT IS OSTEOARTHRITIS (OA) OF THE KNEE?

© DePuy Synthes 2019. All rights reserved. 110162-190323 DSUS 05/19

1. TYLENOL® is a registered trademark of McNeil-PPC, Inc.2. Celebrex® is a registered trademark of Pfizer Inc.3. Voltaren® is a registered trademark of Novartis Pharmaceuticals Corporation.4. Ultram ER® is a registered trademark of Ortho-McNeil, Inc.5. MOTRIN® is a registered trademark of McNeil-PPC, Inc.6. Altman R, Lim S, Steen RG, Dasa V (2015) Hyaluronic Acid Injections Are Associated

with Delay of Total Knee Replacement Surgery in Patients with Knee Osteoarthritis: Evidence from a Large U.S. Health Claims Database. PLoS ONE 10(12): e0145776. doi:10.1371/journal.pone.0145776

7. MONOVISC full prescribing information8. Hyaluronic acid and derivatives (Rx). https://www.modahealth.com/pdfs/med_crite-

ria/HyaluronicAcidDerivatives.pdf. Accessed June 18, 2019.

For more information or to find a doctor near you, go to www.orthovisc.com or call DePuy Synthes Mitek Sports Medicine at 1-800-382-4682

MONOVISC® is a registered trademark and manufactured by Anika Therapeutics, Inc. The third party trademarks used herein are the trademarks of their respective owners.

Important Safety InformationMONOVISC High Molecular Weight Hyaluronan is indicated in the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative nonpharmacologic therapy and to simple analgesics, e.g., acetaminophen. In clinical stud-ies, the most commonly reported adverse events were arthralgia, joint swelling and injection site pain.

MONOVISC is contraindicated in patients with known hypersensitivity to hyaluronate formulations or known hypersensitivity (allergy) to gram positive bacterial proteins. MONOVISC should not be injected in pa-tients with infections or skin diseases in the area of the injection site or joint. MONOVISC should not be administered to patients with known bleeding disorders. Intra-articular injection of sodium hyaluronate preparations has occasionally been associated with allergic/anaphylac-tic reactions and transient hypotension, which have generally resolved spontaneously or after conservative treatment.

DePuy Synthes Mitek Sports Medicine is a global leader in orthopaedic solutions and is dedicated to providing the tools needed to help you move and feel like yourself again.

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KEEP TRACK OF YOUR INJECTION APPOINTMENT HERE

MONOVISC injection scheduled:

Date: Time:

Distributed by:DePuy Synthes Mitek Sports Medicine325 Paramount DriveRaynham, MA 02767Tel: +1 (800) 382-4682

www.depuysynthes.com

Your knee pain, the impact it is having on your life and what has or has not worked previously will help you and your Doctor decide on what treatment option to use next.

Below are some common treatment options that may provide pain relief from OA of the knee.

MONOVISC is an FDA-approved therapy made from ultra-pure, high molecular weight hyaluronic acid. MONOVISC is a knee injection that may help to restore the joint fluid that cushions, protects and lubricates your knee joint.

MONOVISC is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics (e.g., acetaminophen).

Osteoarthritis is a degenerative, progressive disease. Ignoring its symptoms or modifying your lifestyle will not make it better.

OA STAGES FIND THE RIGHT TREATMENT FOR YOU

WHAT IS MONOVISC®?

Lifestyle & Exercise• Weight management• Strength training• Acupuncture

Over-the-Counter (OTC) Pain Relievers• Acetaminophen (TYLENOL1)

Prescription Pain RelieversCelebrex2, Voltaren3, Ultram ER4, and others

Drugs that Treat InflammationNonsteroidal anti-inflammatory drugs (NSAIDS) including ibuprofen (MOTRIN5)

Joint Fluid TreatmentHyaluronic acid injections into the knee joint, such as MONOVISC® High Molecular Weight Hyaluronan

Mild to Moderate OA As OA progresses, healthy joint fluid begins to break down

Severe OA Without healthy joint fluid, your knees become sore and swollen

Knee pain is not an indicator of how far your OA of the knee has progressed, as pain is different for each patient. Be sure to monitor your knee pain and talk with your doctor about the impact it is having on your life so you can find the relief you need based on your stage of knee OA.

• FDA approved.

• A non-avian sourced viscosupplementation derived from bacterial cells.

• Contains the highest amount of hyaluronan available for a single injection.8

• Administered in your doctor’s office.

• May provide pain relief from OA of the knee for up to six months.7

• Clinical studies showed no significant difference in adverse events for one repeat treatment course, but the number of injections right for you is a decision you and your doctor can make together. Consult your insurance provider to learn about coverage for any additional treatments you may receive.7

• Clinical data shows that OA patients who are treated with hyaluronic acid injections may delay total joint replacement surgery for up to an average of 3.6 years.6

• Covered by Medicare and most Commercial plans. For information regarding your MONOVISC coverage, ask your physician to contact our hotline at 1-866-633-VISC (8472) or your insurance provider.

MONOVISC FACTS

AFTER A MONOVISC INJECTION…

• Avoid strenuous activities (high-impact sports like jogging or tennis) or prolonged weight bearing for approximately 48 hours following the injection. Consult your doctor regarding appropriate time to resume such activities.

• The most commonly reported adverse events observed in the original clinical studies were: arthralgia, joint swelling and injection site pain. MONOVISC should not be injected in patients with infections or skin diseases in the area of the injection site or joint or with known systemic bleeding disorders. If you have any known allergies, talk to your doctor to determine if this product is right for you.

Joint fluid

Cartilage

Bone

Unhealthy joint fluid

Eroded cartilage

Bone spurs

Damaged cartilage

Degraded synovial fluid

Healthy KneeFluid cushions and lubricates your knees