What are Hyaluronic Acid Injections?
Hyaluronic acid injections, also known as viscosupplementation, are a treatment for knee osteoarthritis that involves injecting hyaluronic acid directly into the knee joint.
Hyaluronic acid is a natural substance found in joint fluid that helps lubricate and cushion the knee. As osteoarthritis progresses, the amount and quality of hyaluronic acid in the joint decreases.
Hyaluronic acid injections help restore some of that lubrication and cushioning, which can reduce pain and improve mobility.
Who is a Good Candidate?
Hyaluronic acid injections may be a good option for people who:
- Have mild to moderate knee osteoarthritis
- Have not found adequate relief with physical therapy, anti-inflammatory medications or cortisone injections
- Cannot tolerate anti-inflammatory medications (such as Advil, Motrin or Aleve) due to stomach, kidney or heart concerns
- Want to delay or avoid knee replacement surgery
This treatment is generally less effective for severe, bone-on-bone arthritis.
What to Expect
Before the Procedure
You will meet with a sports medicine provider to review your health history and discuss whether hyaluronic acid injections are right for you. If you decide to move forward with treatment, be sure to:
- Inform your provider if you take blood thinners or have any allergies, particularly to poultry or eggs, as some hyaluronic acid products are derived from rooster combs.
- Wear comfortable clothing that allows easy access to your knee.
- Eat a light meal before your appointment to help prevent lightheadedness.
During the Procedure
Injections take only a few minutes.
During the procedure:
- The skin over your knee is cleaned and numbed with a local anesthetic.
- If there is excess fluid (swelling) in the knee, it may be drained before the injection.
- The hyaluronic acid gel is injected directly into the knee joint.
After the Procedure
You may experience temporary soreness, swelling or stiffness in the treated knee. These symptoms are normal and usually improve within one to two days.
To support recovery, we recommend that you:
- Avoid strenuous activity, such as jogging, heavy lifting or prolonged standing, for one week after your injection.
- Apply ice to the knee for 15-20 minutes at a time if needed for post-injection discomfort.
- Use anti-inflammatory medications or Tylenol for pain relief.
- Resume normal daily activities as tolerated and follow any instructions provided by your care team.
If you experience severe pain, significant swelling, redness, warmth, fever or any signs of infection after your injection, contact your doctor’s office immediately or go to the nearest emergency room.
Frequently Asked Questions
Are hyaluronic acid injections safe?
Yes, hyaluronic acid injections are generally well tolerated.
The most common side effects are mild and temporary, including:
- Pain or soreness at the injection site
- Minor swelling or stiffness in the knee
- Warmth or redness around the joint
Serious complications such as infection or severe allergic reactions are rare.
Do hyaluronic acid injections work?
Results vary from person to person. Some patients experience significant relief, while others may notice only modest improvement.
Viscosupplementation does not cure arthritis or regrow cartilage—it is designed to manage symptoms and improve quality of life.
When will I see results?
Viscosupplementation is not a quick fix. Unlike cortisone injections, which may provide relief within days, hyaluronic acid injections work more gradually.
Most patients begin to notice improvement in pain and function within four to eight weeks after treatment.
How long do hyaluronic acid injections last?
When effective, pain relief typically lasts six to 12 months.
Compared with cortisone injections, hyaluronic acid injections may take longer to begin working but often provide longer-lasting relief. If your initial treatment is helpful, repeat injections may be performed every six to 12 months. Studies have shown that repeat treatments can maintain or further improve pain relief for some patients.
What are the limitations?
Hyaluronic acid injections do not cure osteoarthritis or reverse joint damage. They work best for mild to moderate arthritis and may not be effective for everyone.
Results are temporary, and repeat treatments may be needed to maintain benefit.
Are hyaluronic acid injections covered by insurance?
Insurance plans generally cover hyaluronic acid injections after documentation of failed conservative treatments, which typically include:
- Completion of a course of physical therapy
- A prior cortisone injection that did not provide lasting relief
- Evidence of anti-inflammatory medication use, such as Advil, Motrin or Aleve
If these conservative measures have not been completed, insurance approval cannot be guaranteed.
Our office staff can help verify your specific insurance coverage and any out-of-pocket costs before scheduling your procedure.
How much do hyaluronic acid injections cost?
Depending on your insurance, a $100 option may be available.
Our office staff can help verify your specific insurance coverage and discuss any out-of-pocket costs before scheduling your procedure.