Application
Intended for physicians and medical staff.
Crespine Gel is injected intra-articularly into the affected joint. A single injection of two millilitres per treatment course is intended.
Treatment areas
Osteoarthritis of knee or hip. Indicated for pain and joint function disorders as a result of degenerative deficits as a single injection treatment course. After the injection hyaluronic acid forms a layer on the surface of the joint cartilage and improves the pain symptoms.
It is possible to treat several joints at the same time. The common contraindications for intra-articular injection have to be observed.
Preparation and administration
- A full anamnesis must be performed before treatment, in order to rule out any contraindications.
- The practitioner has to advise the patient of all precautions and possible adverse effects prior to treatment.
- The area to be treated must be carefully prepared with an antiseptic.
- The needles used for implantation have to be selected according to their suitability for intra-articular injection.
- To minimize the likelihood of intravascular injection, aspiration should be performed before the application. If blood is aspirated, the needle must be repositioned. The absence of blood does not ensure the avoidance of intravascular injection.
- The injection technique is of decisive importance for the final outcome.
- Must only be used by authorised medical personnel in agreement with the regional legal regulations.
- It is possible to treat several joints at the same time.
The instructions for use do not specify access routes per joint or a fixed needle gauge — the needle is selected according to its suitability for intra-articular injection.
Contraindications and warnings
- autoimmune illnesses
- incompatibility with gram-positive bacteria
- active inflammation or infection processes
- anticoagulant therapies
- known allergy to hyaluronic acid
- patients with multiple allergies should be excluded from treatment
- Only intended for intra-articular injection and must not be injected into blood vessels. This could lead to an occlusion of the vessels and embolism.
- No clinical data is available on administration during pregnancy or lactation, or to adolescents under 18 years of age.
- Must not be used in patients with existing infections and inflammation processes in the vicinity of the implantation site.
- Patients should not take anticoagulant medication (such as aspirin), steroids or high doses of vitamin E before treatment.
Adverse effects
As with any other injection, patients may suffer from the following. These reactions normally disappear within 2 to 5 days of the injection.
- temporary erythema
- slight swelling
- pain
- sensation of heat
Hypersensitivity to hyaluronic acid after the injection occurs in less than 1 % of cases, manifesting as extensive erythema and swelling. These reactions can occur immediately after the injection or up to 2 to 4 weeks later. The clinical data show that these hypersensitivity reactions are mild or moderate and last for a maximum of two weeks.
Wording from the instructions for use, date of information 05.2019. The version supplied with the product prevails.
What the studies observed
In the cohort of Suppan et al. (2026, n = 111), adults with radiographically confirmed knee osteoarthritis of Kellgren-Lawrence grades I to III — grade IV where surgery was declined — received a single intra-articular injection of 2 ml, with assessments at three and twelve months.
Tolerability differed between studies: 1.8 % reported transient knee pain in Suppan et al., while in Bashaireh et al. 33 of 84 analysed participants (39 %) had increased pain and limited knee mobility 72 hours after injection. All events were local and transient in both.
Full evidence with limitations
Variants
Crespine® Gel
Standard variant, without local anaesthetic.
Crespine® Gel +
Additionally contains the local anaesthetic prilocaine, released slowly from the hyaluronic acid matrix.