Cingal® Injection Therapy

Purpose-built treatment for inflamed osteoarthritic joints

Cingal® is a clinically engineered injection therapy

Designed for patients with symptomatic, inflamed osteoarthritis of the knee, who need both rapid pain relief and longer-term joint support. It combines a high-dose hyaluronic acid with a carefully selected corticosteroid in a single, stable formulation, created specifically to address a common and challenging clinical presentation.

This is not a mixed injection. It is a purpose-built product, supported by clinical data, designed to deliver predictable outcomes in real-world practice, with an improved safety profile.

Unique Technology

A hybrid formulation, engineered – not improvised

High-dose hyaluronic acid (88 mg) with a naturally optimised molecular weight profile designed to support synovial health, lubrication, and joint mechanics.
Triamcinolone hexacetonide (18 mg) — a longer-acting, intra-articular steroid chosen for its targeted anti-inflammatory effect and favourable safety profile within joints.

The formulation is manufactured as a single, stable injection. This avoids the variability, dilution, and compatibility concerns associated with mixing steroid and HA products at the point of care.

The result is a treatment designed to address both:

The inflammatory component driving pain
The mechanical and biological environment of the osteoarthritic joint

Clinical Rationale

Why combine HA and steroid – properly

Inflamed osteoarthritis is not simply a lubrication problem. In many patients, synovitis and inflammatory mediators drive pain, limit movement, and reduce tolerance to rehabilitation.

Cingal is designed to:

Provide early pain reduction through targeted steroid action
Support longer-term joint function through high-dose hyaluronic acid
Reduce the need for staged or repeat injections
Offer a predictable, reproducible alternative to ad-hoc combination approaches

Clinical studies demonstrate high responder rates and meaningful pain reduction, supporting its use as a single-injection option for appropriate patients.

Clinical and Scientific Data Review

Fast acting

59% pain reduction 1 week with 89% response rate¹

Long lasting

72% pain reduction at 26 weeks with 92% response rate¹

Protects cartilage

Maintains the chondro-protective effect of pure hyaluronic acid²

The Cingal level 1 study was carried out 3 times with the same results each time across a 6-year time span. Each study was a blinded randomised control study.

Triamcinolone hexacetonide compared with triamcinolone acetonide in the management of osteoarthritis of the knee in adults a pilot audit study³

Read Study

Comparison of efficacy between triamcinolone acetonide and triamcinolone hexacetonide for intraarticular therapy in juvenile idiopathic arthritis: a retrospective analysis4

Read Study

Cingal contains 18mg Triamcinolone Hexacetonide (TH)

TH is a far more efficient steroid, so it is optimised at a recommended lower dose of 18mg. Compared to Kenalog (TA), TH’s effect lasts significantly longer, has a greater improvement in pain and quality of life scores, and is associated with a lower risk of toxic effects to healthy cartilage and reduced systemic side effects.

Mr Barkatalli explains what Cingal is, and gives his thoughts about the combination of HA and steriod

Where Cingal® Fits in Clinical Practice

A practical option for a common presentation

Cingal is typically considered for patients who:

Have symptomatic knee osteoarthritis with a clear inflammatory component
Require faster symptom control to enable activity or rehabilitation
Have not achieved sufficient relief with conservative care alone
Are not yet candidates for surgical intervention

In practice, clinicians often use Cingal:

As a step beyond pure HA when inflammation is limiting progress
To reduce pain and swelling before physiotherapy or strengthening
As part of a broader joint preservation or non-operative pathway
As a best practise option when compared to a steroid alone, or an in-clinic cocktail mix with HA

Supported by Eos Active

Cingal is not positioned as a standalone product. At Eos Active, we support its use as part of a considered, ethical, and sustainable injection service, one that works for clinicians, clinics, and patients.

Our support is designed to remove friction around adoption, communication, and delivery, so the focus stays on good clinical decision‑making rather than product justification.

Clinical confidence and education

Ongoing education around injection therapy, osteoarthritis management, and treatment selection
Access to a growing clinical library with key papers, summaries, and practical guidance
Support in understanding where Cingal fits relative to pure HA, PRP, and other non‑operative options

Patient communication and consent support

Clear, balanced patient‑facing materials explaining what Cingal is, and what it is not
Language that helps patients understand the rationale for combined treatment without overselling
Resources that support informed consent and realistic expectation setting

Practice integration

Guidance on how Cingal can sit within existing clinic pathways
Support aligning injection therapy with physiotherapy, rehabilitation, and longer‑term joint care
Help structuring services so treatments feel joined‑up rather than transactional

A partnership approach

Direct access to Eos Active for discussion, questions, and support
A long‑term relationship built around service development, not short‑term volume
A shared focus on evidence‑led care and maintaining professional credibility

Cingal in summary

A considered choice for inflamed OA

Cingal is best viewed as a deliberate clinical decision to offer safe, rapid and longer-lasting relief from inflamed osteoarthritis.

For the right patient, at the right time, it offers a balanced approach to pain relief and joint support, delivered through a single, purpose-built injection. Cingal complements other joint preservation options, fitting naturally alongside physiotherapy, weight management, bracing, and longer-term joint support strategies.

Many of those other complementary options are available within the Eos Active Portfolio. Take a look.

Eos Active Portfolio

Book a call or get in touch

Discuss with our Managing Director, Jim, to learn more about Orthovisc, and so we know where and how to work best with you.