Crespine Gel+

Indication

Crespine Gel+ is indicated for pain and functional impairment of joints caused by degenerative changes — osteoarthritis of the knee and of the hip. It is intended for joints with a degenerated cartilage surface and pathologically altered synovial fluid.

Mode of action

The cross-linked hyaluronic acid supplements the altered synovial fluid and is intended to improve lubrication and cushioning of the joint; the published cohort data describe reduced pain and improved joint function after a single injection. Prilocaine hydrochloride is an amide-type local anaesthetic that acts at the injection site. The implant is resorbed slowly, so one injection covers a full treatment cycle.

Composition per 1 ml

Pack and handling

• One sterile 2 ml prefilled syringe with integrated Luer-Lock connection, sealed in a blister. Needles are not included.
• The pack contains the instructions for use and batch labels for the patient record.
• Store at 2–25 °C, do not freeze. Shelf life: three years from the date of manufacture.
• Single use. The injection is placed intra-articularly under aseptic conditions; the injection technique is decisive for the result.

Clinical evidence

In a prospective, single-arm observational study at a Malaysian Ministry of Health hospital, 111 patients with knee osteoarthritis received a single 2 ml injection of Crespine Gel+; 92 completed twelve months. Adjusted KOOS4 scores improved by 8.8 points (95 % CI 5.5–12.1) and pain on the visual analogue scale fell by 1.6 points (95 % CI −2.0 to −1.3) at twelve months, both p < 0.001, with no significant change between month 3 and month 12. Two patients (1.8 %) reported transient injection pain; no serious adverse events occurred. The study had no control group.

Suppan VKL et al. Long-term functional and clinical outcomes of intraarticular double-cross-linked high molecular weight hyaluronic acid (Crespine Gel Plus) injection in knee osteoarthritis: a one year prospective study. BMC Musculoskelet Disord. 2026;27:209. Source

All study details

Safety information

Transient reactions at the injection site — pain, swelling, redness, warmth — can occur in the first days after injection and usually subside within a few days. In the 2026 study, 1.8 % of patients reported transient injection pain resolving within 48 hours. Hypersensitivity to hyaluronic acid is rare and may appear with a delay. Prilocaine can cause the systemic effects typical of amide-type local anaesthetics.

Contraindications (selection)

• known hypersensitivity to hyaluronic acid or to amide-type local anaesthetics
• active inflammation or infection in or near the joint, or skin disease at the injection site
• autoimmune diseases
• intolerance to proteins of gram-positive bacteria
• treatment with anticoagulants
• congenital or idiopathic methaemoglobinaemia

Precautions

Not for intravascular injection; aspirate before injecting. No data are available for pregnancy, breastfeeding or patients under 18 years. Use with caution in patients taking medicines that can induce methaemoglobinaemia and in patients with severe renal, hepatic or cardiac impairment.

This summary does not replace the instructions for use (IFU) supplied with the product. Contraindications, warnings and precautions are listed in full in the IFU.

For patients

Crespine Gel+ is a gel made of hyaluronic acid, a substance that occurs naturally in the joint, combined with a local anaesthetic. Your doctor injects it into the affected joint to supplement the joint fluid. Whether the treatment is suitable for you, what you can expect and which alternatives exist is something only your doctor can assess. Please discuss it with an orthopaedic specialist.

Availability

Crespine Gel and Crespine Gel+ are supplied through our distribution partners. Healthcare professionals can contact us for the partner responsible for their country; companies interested in distribution can find the details on the partner page.