Adequan® vs. Legend® vs. Pentosan for Equine Osteoarthritis 🐴💉
Osteoarthritis (OA) is the most common joint disease in horses, robbing equine athletes of peak performance and affecting the comfort of aging companions. In the race to preserve joint health, three heavy hitters dominate the injectable scene: Adequan® i.m., Legend®, and Pentosan Polysulfate Sodium (Zycosan® or compounded).
They’re not interchangeable. They don’t act the same. And they come with unique benefits—and risks.
So, which one is best for your horse’s needs?
🔍 Key Takeaways: Adequan® vs. Legend® vs. Pentosan
| 🧠 Question | 🐎 Short Answer |
|---|---|
| Which drug actually repairs cartilage? | Adequan®—it stimulates cartilage regeneration and inhibits degradation. |
| Which works fastest for inflammation and pain? | Legend®, especially IV, reduces synovial inflammation quickly. |
| Which has the broadest anti-inflammatory effects? | Pentosan (Zycosan®)—targets inflammation and blood flow, but with anticoagulant risks. |
| Which is the safest overall? | Adequan®—minimal side effects, no clotting issues. |
| Can horse owners administer any of these at home? | Adequan® and Zycosan®—both are IM injections that can be taught to owners. |
| Which is most expensive? | Legend®—higher per-dose cost and typically requires a vet for administration. |
| Which is FDA-approved? | All three—Adequan®, Legend®, and Zycosan® are FDA-approved; compounded pentosan is not. |
🧬 How Do These Medications Actually Work?
| 🧪 Product | 🎯 Primary Target | ⚙️ Mechanism of Action | 🛠️ Disease Modification |
|---|---|---|---|
| Adequan® i.m. | Cartilage & synovial fluid | Stimulates cartilage repair, inhibits degrading enzymes, restores HA | Strong |
| Legend® | Synovial fluid & membrane | Restores lubrication, reduces inflammation, stimulates HA | Moderate |
| Pentosan (Zycosan®) | Cartilage, synovium, circulation | Inhibits cytokines, improves HA, enhances circulation, mild anticoagulant | Moderate |
💡 Expert Tip: These drugs shine at different stages of OA. Adequan® is best for cartilage-focused disease, Legend® for fluid/synovitis issues, and Pentosan when broad inflammation control is needed.
💉 What’s the Dosing & Who Can Administer It?
| 💊 Product | 📍 Route | 📅 Dosing Schedule | 👩⚕️ Who Administers? |
|---|---|---|---|
| Adequan® i.m. | Intramuscular | 500 mg every 4 days × 7 doses | Owner or vet |
| Legend® | IV or Intra-Articular | 40 mg IV or 20 mg IA, once weekly × 3 | Veterinarian only |
| Zycosan® | Intramuscular | 3 mg/kg weekly × 4 doses | Owner or vet |
| Compounded Pentosan | Variable | Off-label, varies widely | Typically vet-recommended |
💡 Pro Insight: IM meds like Adequan® and Zycosan® save money by avoiding vet visit fees—if you’re comfortable with injections.
⚠️ Are There Side Effects You Should Worry About?
| 🧴 Medication | ⚠️ Side Effects | ⛔ Major Precautions |
|---|---|---|
| Adequan® i.m. | Very rare; excellent safety | Not for food animals; unknown in breeding stock |
| Legend® | Transient lethargy (IV), joint flare (IA) | Use sterile technique for IA; rule out fractures |
| Zycosan® | Anticoagulant effects, injection site reactions | Avoid pre/post-surgery, clotting disorders, or NSAIDs |
| Compounded Pentosan | Similar risks as Zycosan®, plus quality inconsistency | Not FDA-reviewed—potency and sterility may vary |
🚨 Real Risk: Pentosan’s anticoagulant effects can lead to complications around surgery, injury, or intense exercise (e.g., EIPH in racehorses). It’s not a casual choice.
💰 How Much Does It All Cost?
| 💸 Drug | 💵 Cost (Approximate) | 🧾 Notes |
|---|---|---|
| Adequan® (7-dose course) | $360–$370 | Lower cost per dose; owner-administered |
| Legend® (3 IV doses) | $270–$375 + vet fees | Higher due to IV/IA administration |
| Zycosan® (4 doses) | ~$399 | Single-use vials; discard excess |
| Compounded Pentosan | $100–$250 | Cheapest—but unregulated |
💡 Money Talk: If budget is tight and safety is key, Adequan® often hits the sweet spot.
🎯 Which Horses Benefit Most from Each?
| 🐴 Type of Horse | ✅ Best Fit |
|---|---|
| High-performance athlete | Legend® for fast relief from synovitis; Adequan® for cartilage support |
| Early OA or chronic joint wear | Adequan® for disease modification |
| Older/retired horse with stiff joints | Pentosan or Adequan®, depending on bleeding risk |
| Cost-conscious owner | Adequan® or compounded pentosan (if risk is acceptable) |
| Horses prone to EIPH or surgery | Avoid Pentosan due to bleeding risk |
🤝 Can You Combine These Meds for Better Results?
Yes—but do it smartly.
- Adequan® + Legend® is a popular combo to target cartilage repair and synovial fluid.
- Pentosan + HA + glucosamine is commonly used in compounded regimens but lacks FDA-reviewed synergy studies.
- Always space out injections and monitor closely—especially when using Pentosan alongside NSAIDs or during intense training periods.
💬 Expert Caution: FDA studies don’t cover combo protocols, so these are off-label and based on clinical judgment.
🧭 Final Thoughts: What Should Guide Your Decision?
✅ Use Adequan® if your horse has:
- Evidence of cartilage loss
- Recurrent stiffness
- You want a safe, self-administered, long-term strategy
✅ Use Legend® if:
- Rapid symptom relief is needed
- Synovitis is the main issue
- A vet is on-hand for injections
✅ Use Zycosan® (or Pentosan) if:
- You need broad anti-inflammatory coverage
- You understand the anticoagulant risks
- You can monitor your horse carefully
🔚 The Bottom Line
Choosing between Adequan®, Legend®, and Pentosan isn’t just about cost or brand familiarity. It’s about targeting the right part of the joint, matching your horse’s condition, and balancing benefits with safety risks.
Every horse is different. Talk to your vet, get an accurate diagnosis, and build a long-term plan. The right drug—used the right way—can make all the difference in preserving comfort, soundness, and performance.
🏇 OA doesn’t have to be the end of the road. With the right injectable, it could just be the start of a new stride.
FAQs
🗨️ Comment: “Can I just use Legend® if my horse is only stiff after intense workouts?”
Legend® is an excellent choice in this scenario—but with key caveats. If your horse shows transient post-exercise stiffness, that often points to synovial membrane irritation rather than advanced cartilage damage. Legend®, especially when administered intravenously, works rapidly to rehydrate and restore the viscosity of synovial fluid, reducing friction and inflammatory cell infiltration. It does not rebuild cartilage, but it stabilizes the joint environment in horses experiencing inflammatory synovitis, especially after strenuous activity.
If stiffness is occasional and activity-related, a 3-dose IV Legend® protocol spaced a week apart may be sufficient. However, if signs become persistent, adding a cartilage-targeting agent like Adequan® could provide more comprehensive joint protection over time.
| 🧪 Legend® for Post-Workout Stiffness | 🧍♂️ Best For | ⚠️ Limitations |
|---|---|---|
| Rapid synovial relief 💧 | Acute synovitis, high-motion joints 🏇 | No cartilage repair; temporary relief only ⏳ |
🗨️ Comment: “My vet suggested Adequan® every 6 months as a maintenance plan. Is that evidence-based?”
Partially. While the FDA-approved protocol for Adequan® i.m. is a 7-dose series over 28 days, there’s no official label guidance for maintenance intervals beyond that. However, clinical experience and published case reports support repeating the full 7-dose series every 6 months in horses with chronic DJD or as a prophylactic protocol in working athletes.
This biannual regimen appears to maintain synovial HA levels and chondrocyte function, particularly in disciplines involving repetitive joint strain (e.g., barrel racing, show jumping). The mechanism here lies in PSGAG’s ability to suppress matrix-degrading enzymes while stimulating anabolic repair at the cartilage level, making it a true disease-modifying osteoarthritis drug (DMOAD).
| 🕰️ Maintenance Adequan® Use | 🔄 Frequency | 🔬 Evidence Type |
|---|---|---|
| Off-label but common 🧬 | Every 6 months 📅 | Case-based & empirical 👩⚕️ |
🗨️ Comment: “Why does Pentosan have bleeding risks when it’s not a blood thinner like heparin?”
Pentosan polysulfate sodium (PPS) isn’t a full anticoagulant like warfarin or heparin, but it is a heparinoid—meaning it shares structural and biochemical features with anticoagulant molecules. PPS has weak antithrombotic effects due to its high degree of sulfation, which interferes with clotting cascades, particularly the intrinsic pathway.
The key clinical effect is an elevated activated Partial Thromboplastin Time (aPTT) for up to 24 hours post-injection. This prolongation translates to a higher risk of spontaneous bleeding, particularly in horses undergoing surgery, with exercise-induced pulmonary hemorrhage (EIPH), or on concurrent NSAIDs. While it’s not dangerous in all patients, horses with preexisting clotting disorders or those receiving other anti-inflammatory agents should be monitored closely or considered poor candidates.
| ⚠️ PPS Bleeding Risk | 🧬 Why It Happens | 🏇 Clinical Implications |
|---|---|---|
| Weak anticoagulant activity 🩸 | Sulfated polysaccharide structure 🧪 | Avoid pre-surgery or with NSAIDs 🔪 |
🗨️ Comment: “Can I rotate between these drugs to cover all joint functions?”
Yes, strategically rotating or sequencing these medications can enhance therapeutic outcomes—if done thoughtfully. Each drug targets distinct layers of joint pathology:
- Adequan®: Repairs cartilage matrix 🧱
- Legend®: Stabilizes synovial fluid and reduces membrane inflammation 💧
- Pentosan (Zycosan®): Broad-spectrum anti-inflammatory with vascular benefits 🌿
Rotating them involves giving Adequan® for cartilage restoration, followed by Legend® to maintain joint lubrication, and optionally adding Zycosan® during periods of high-intensity work or systemic inflammation. However, never use Zycosan® concurrently with NSAIDs or close to surgery due to clotting risks.
Veterinarians often design custom cycles based on work schedule, flare-ups, and recovery periods. That said, no FDA study supports concurrent use, so it remains an off-label approach requiring clinical discretion.
| 🔁 Rotational Use Plan | 🔧 Goal | 🔒 Risk Management |
|---|---|---|
| Adequan® → Legend® → PPS 🧭 | Address all joint layers holistically 🧬 | Avoid overlapping anticoagulants ❗ |
🗨️ Comment: “Is compounded Pentosan really that different from Zycosan®?”
Yes—significantly. While both products may contain the same nominal active ingredient (pentosan polysulfate sodium), their regulatory oversight, manufacturing quality, and clinical backing differ radically.
- Zycosan® is FDA-approved, meaning it’s undergone rigorous pharmacokinetic studies, dose titration trials, and multi-center field studies. It is produced under Good Manufacturing Practices (GMP) and includes adverse event reporting.
- Compounded pentosan, by contrast, is not reviewed by the FDA, often made from bulk substances, and may vary in purity, concentration, sterility, and efficacy. Inconsistencies in batch-to-batch bioavailability can lead to under- or over-dosing, and there’s no obligation to report side effects.
Though often cheaper, compounded versions pose risks not visible on the label. The availability of Zycosan® makes a regulated choice possible, which the FDA strongly prefers when an approved alternative exists.
| ⚖️ Zycosan® vs. Compounded PPS | 🏛️ FDA Review | 🧪 Clinical Consistency |
|---|---|---|
| Zycosan® ✅ | Full approval; strict GMP 🧬 | High batch-to-batch consistency |
| Compounded ❌ | No FDA review; unregulated 💊 | Variability in strength/purity ⚠️ |
🗨️ Comment: “Can you give these meds long-term without side effects?”
It depends on which medication you’re using and how frequently it’s administered.
- Adequan® i.m. has no known cumulative toxicity. Horses have tolerated doses 5× the label recommendation over 12 weeks without adverse effects. Long-term intermittent use (e.g., biannual cycles) is generally safe and widely practiced.
- Legend®, when used IV, has no cumulative effects reported. However, intra-articular (IA) administration, if performed too frequently, can pose risks related to joint trauma or infection, not the drug itself.
- Zycosan® (Pentosan) is where caution is needed. Long-term data on repeat IM cycles is not yet available for Zycosan®. In human medicine, retinal pigment changes have been observed with prolonged oral use of PPS. Though no such link has been proven in horses, vigilance is warranted with chronic administration.
Ultimately, ongoing monitoring, including bloodwork and performance evaluations, is crucial for any extended OA protocol.
| 📆 Long-Term Use Safety | 🩺 Known Risks | 🔍 Monitoring Advice |
|---|---|---|
| Adequan® – Safe 🟢 | None known | Repeat every 6 months |
| Legend® – Safe (IV) 🟢 / Risk (IA) 🟠 | Joint trauma risk if IA too often | Monitor lameness patterns |
| Zycosan® – Unknown (Long-Term) 🟡 | Potential for systemic issues | Caution with repeat cycles |
🗨️ Comment: “My horse has arthritis in multiple joints. Is one injection enough to treat the whole body?”
Systemic injectable treatments like Adequan® and Zycosan® are absorbed into the bloodstream, allowing them to reach multiple joints after a single intramuscular injection. This makes them ideal for horses with multifocal osteoarthritis, where localized joint injections like intra-articular Legend® may be insufficient or impractical.
However, the degree of therapeutic concentration that each joint receives can vary depending on vascularization, joint activity, and degree of inflammation. For instance, joints with greater motion or synovitis may absorb more of the circulating compound. This systemic distribution is also why owners often observe global improvements in stiffness or stride after 2–3 doses.
| 🌐 Systemic Reach | 💉 Drug Type | 💥 Best Use Case |
|---|---|---|
| Yes (Multiple joints) ✅ | Adequan®, Zycosan® | Horses with widespread DJD 🐴 |
| Localized only ❌ | Legend® IA | Single-joint lameness 🎯 |
Clinical Note: If one joint is acutely painful or swollen, targeted IA therapy can be combined with systemic treatment for a dual-layered approach.
🗨️ Comment: “Can I use these medications in young horses to prevent arthritis?”
While none of these injectables are labeled for prophylactic use, some veterinarians utilize Adequan® i.m. or Pentosan off-label in young performance horses to support joint integrity during early skeletal stress periods—especially in disciplines like racing, barrel racing, or early-start training programs.
The rationale hinges on their disease-modifying capabilities—namely, the stimulation of proteoglycan synthesis, inhibition of degradative enzymes, and support of healthy synovial fluid production. These actions may help mitigate microtrauma and reduce the risk of premature degenerative changes.
However, this should be approached strategically, as no long-term studies confirm prevention efficacy in asymptomatic animals. Prophylactic regimens are typically brief and paired with orthopedic evaluations, rest cycles, and nutritional support.
| 🐣 Prophylactic Use | ✔️ Commonly Used | ⚠️ Evidence Level |
|---|---|---|
| Not FDA-indicated 🚫 | Adequan®, Pentosan (off-label) | Low (anecdotal + empirical) 📚 |
Critical Insight: The use of injectables for prevention should be guided by early diagnostic imaging, conformation evaluation, and workload—not as a universal protocol.
🗨️ Comment: “My horse had a reaction to a Legend® IA injection. Should I avoid it altogether now?”
A localized flare-up post-IA injection, also called a “joint flare”, is an inflammatory reaction to either the hyaluronate solution or the mechanical trauma of needle entry. It is not uncommon and usually resolves within 24–72 hours with NSAIDs and supportive care.
If your horse experienced marked lameness, heat, or swelling after Legend®, the first step is to confirm it wasn’t septic arthritis, which is far more serious and requires immediate intervention. If infection is ruled out and the reaction was inflammatory, your vet may:
- Switch to IV Legend®, which bypasses the joint entirely but still delivers systemic HA benefits.
- Pre-treat with NSAIDs or corticosteroids, though this must be done cautiously.
- Consider switching to Adequan® or Pentosan, which do not carry the same IA-specific risk.
| 🔁 Alternative Plan | 🧪 Equivalent Option | 💊 Route Change |
|---|---|---|
| IV Legend® 💉 | Same active ingredient, fewer flares | Safer for sensitive joints 🔄 |
| Switch to PSGAG or PPS 🔄 | Different MOA but supportive | IM only ✔️ |
Professional Reminder: Any IA treatment should follow stringent aseptic technique to minimize flare risk. Recurrence after a second attempt may warrant discontinuation of IA HA entirely.
🗨️ Comment: “How do I know if my horse is a better candidate for Legend® or Adequan®?”
This comes down to accurate diagnosis of the joint pathology. Use diagnostic imaging and joint blocks to differentiate between inflammatory synovitis versus cartilage matrix degradation.
- If lameness is related to soft tissue inflammation, synovial effusion, or joint capsule swelling, Legend® is typically the better first-line.
- If there’s evidence of cartilage thinning, osteophytes, or chronic stiffness without heat/swelling, Adequan® is often more appropriate due to its regenerative properties.
Some horses benefit from a sequence: starting with Legend® to calm acute inflammation, followed by Adequan® for ongoing joint repair.
| ⚖️ Best Fit Breakdown | 🩸 Legend® | 🔩 Adequan® |
|---|---|---|
| Acute synovitis 🧯 | ✅ | ❌ |
| Cartilage wear & tear 🧱 | ❌ | ✅ |
| Effusion & joint swelling 💦 | ✅ | ⚠️ Moderate |
| Chronic stiffness 🚶♂️ | ⚠️ Mild benefit | ✅ |
Precision Tip: Your vet may recommend synovial fluid analysis, which reveals inflammatory markers that can further guide medication choice.
🗨️ Comment: “Can I give my horse Adequan® and also use oral joint supplements?”
Absolutely—when paired correctly. Injectable Adequan® offers targeted cartilage support and enzyme inhibition, while oral nutraceuticals like glucosamine, chondroitin sulfate, MSM, and omega-3s contribute to systemic anti-inflammatory effects, connective tissue resilience, and oxidative stress modulation.
They do not duplicate mechanisms but rather offer complementary pathways. For example, oral glucosamine boosts amino sugar availability for cartilage matrix formation, while Adequan® stimulates chondrocyte activity directly.
For best results:
- Choose products with bioavailable forms (e.g., glucosamine sulfate vs. HCl)
- Ensure supplements are veterinary-grade
- Be consistent with dosing and administration
| 💊 Combo Strategy | 📌 Injectable Role | 🧴 Oral Supplement Role |
|---|---|---|
| Adequan® + oral joint support 🧬 | Cartilage regeneration + enzyme inhibition 🔧 | Systemic support + inflammation reduction 🌿 |
Synergy Tip: Avoid doubling up on similar ingredients to reduce unnecessary cost or overdose risk (e.g., if both injectable and oral products contain HA, space them out).
🗨️ Comment: “Why does my horse seem better after the third Adequan® dose and not earlier?”
This is a hallmark feature of disease-modifying osteoarthritis drugs (DMOADs) like Adequan® i.m. Unlike fast-acting analgesics, Adequan® exerts its therapeutic effects by gradually modifying joint metabolism, requiring time to:
- Reach effective concentrations in joint tissues.
- Suppress matrix metalloproteinases (MMPs) and other degradative enzymes.
- Stimulate anabolic pathways in chondrocytes to increase synthesis of proteoglycans and collagen.
- Enhance synovial fluid quality through increased hyaluronic acid content.
Clinical studies and field reports consistently show observable functional improvement between the third and fifth injections, correlating with cumulative PSGAG deposition in articular cartilage.
| 🕒 Adequan® Response Timeline | 🧬 Biologic Process | 🐎 Expected Clinical Result |
|---|---|---|
| Dose 1–2 🧪 | Initiates enzyme inhibition | Minimal outward changes 👀 |
| Dose 3–5 🔧 | Cartilage synthesis + HA increases | Noticeable stride improvement 💃 |
| Dose 6–7 🧱 | Joint remodeling stabilizes | Peak performance return 📈 |
Vet Tip: Continue the full 7-dose course even if improvement is seen early—it ensures maximal and sustained cartilage protection.
🗨️ Comment: “I’ve heard Pentosan helps with bone remodeling—true or false?”
True—with limitations. Pentosan Polysulfate Sodium (PPS), particularly as Zycosan®, has shown indirect influence on subchondral bone via its effects on microvascular circulation and anti-inflammatory modulation.
Here’s how:
- PPS may improve subchondral perfusion through fibrinolytic activity, enhancing nutrient delivery and waste removal.
- It reduces cytokine-driven bone resorption by inhibiting IL-1β and TNF-α.
- It may help maintain bone-cartilage unit integrity, indirectly supporting osteoblast function and reducing osteoclast overactivity.
However, PPS is not a bone-specific medication. It does not stimulate bone mineralization like bisphosphonates (e.g., tiludronate) and should not be relied on solely for conditions like navicular disease or bone spavin.
| 🦴 Pentosan’s Bone Benefits | 🌿 Mechanism | 📌 Limitation |
|---|---|---|
| Supports vascular supply 💉 | Fibrinolytic & microcirculatory effects | Not osteogenic 🧱 |
| Reduces osteolytic cytokines 🔥 | Anti-inflammatory profile | No direct bone-building action ❌ |
Specialist Note: Consider using PPS in conjunction with targeted bone therapies if subchondral lesions are a concern.
🗨️ Comment: “How do I decide between Zycosan® and compounded pentosan if my budget is tight?”
The decision balances economics versus consistency and oversight. Let’s break it down:
- Zycosan® is an FDA-approved product, backed by:
- Verified clinical trials
- Stringent GMP manufacturing
- Defined dosing accuracy and sterility
- Mandated adverse event reporting
- Compounded pentosan is:
- Often less expensive per vial
- Manufactured under variable conditions
- Not subject to federal testing for purity, potency, or bioavailability
- Lacking published peer-reviewed efficacy data
Although the active molecule is the same, compounded versions can deviate in molecular weight, pH balance, or vehicle compatibility, which may impact absorption and efficacy.
| 💰 Comparing PPS Options | ✅ Zycosan® | ⚠️ Compounded Pentosan |
|---|---|---|
| FDA oversight 🏛️ | Yes | No |
| Clinical data 📚 | Robust & published | Largely anecdotal |
| Cost per dose 💲 | ~$100 | ~$40–$60 |
| Risk of variability ⚠️ | Minimal | Moderate to high |
Guidance: If you’re working with performance horses or those with surgical history, Zycosan® is the safer long-term investment. For low-level cases with budget constraints, some vets may cautiously trial compounded PPS—but only from reputable compounding pharmacies.
🗨️ Comment: “Can Legend® and Adequan® be used at the same time?”
Yes—but the decision must be strategically planned, not casually combined. Legend® (HA) and Adequan® (PSGAG) target distinct anatomical and biochemical layers of joint disease:
- Legend® acts rapidly on the synovial membrane and joint capsule, improving viscosity and reducing leukocyte infiltration.
- Adequan® works deeper, at the articular cartilage level, facilitating matrix repair and suppressing catabolic enzymes.
Concurrent use is typically reserved for:
- Moderate to severe OA cases
- Horses with both effusion and crepitus
- Pre-competition periods where short-term fluid enhancement (Legend®) and long-term matrix support (Adequan®) are both needed
Protocols vary, but common strategies include:
- Starting Adequan® (1st dose)
- Adding IV Legend® weekly during the first 2–3 Adequan® injections
- Monitoring for joint swelling, stiffness reduction, and gait elasticity
| 🧬 Combo Protocol Insight | 💉 Legend® Role | 🔧 Adequan® Role |
|---|---|---|
| Short-term inflammation ↓ | Synovitis relief, HA boost 💧 | Cartilage healing, MMP inhibition 🧱 |
| Long-term structure ↑ | Limited direct matrix repair ❌ | Regenerative action sustained over weeks ✅ |
Clinical Insight: Because both drugs have excellent safety profiles, they can be co-administered—but dosing schedules should avoid overlapping stress on joints through repeated IA injections.
🗨️ Comment: “Do any of these injectables help with post-surgical joint healing?”
Yes—particularly Adequan® and Zycosan®. Following joint surgery (e.g., chip removal, arthroscopy), the intra-articular environment is vulnerable to pro-inflammatory cascades and synovial membrane remodeling. Here’s how injectables may assist:
- Adequan® provides early inhibition of degradative enzymes like stromelysin and collagenase, which can spike post-operatively. It also accelerates proteoglycan replenishment, helping reestablish cartilage balance.
- Zycosan® may suppress systemic and local inflammation, while its fibrinolytic properties may help prevent microthrombi formation in post-surgical vascular beds.
- Legend® is less often used immediately post-op unless synovitis remains prominent, since its intra-articular route may raise infection concerns if aseptic technique is compromised.
| 🛠️ Post-Surgical Support | ⚙️ Best Option | 🧬 Key Action |
|---|---|---|
| Cartilage repair & enzyme suppression 🧱 | Adequan® | Matrix remodeling aid |
| Inflammation + circulation boost 🔄 | Zycosan® | Microvascular recovery |
| Synovial re-lubrication 💧 | Legend® | Limited role; use with caution |
Post-Op Tip: Always wait until initial inflammation subsides before introducing injectables—typically 7–14 days post-surgery, unless directed otherwise by the surgeon.
