Viscosupplementation is a series of one or more injections of hyaluronic acid, a gel-like substance, into the knee joint. It’s designed to supplement the natural fluid that cushions and lubricates the joint, which tends to thin out with osteoarthritis. For some people with knee arthritis, it may help ease pain and improve movement.
A healthy knee contains synovial fluid, which is rich in hyaluronic acid. It helps the joint glide smoothly and absorb shock. In osteoarthritis, this fluid becomes thinner and less effective, which can add to stiffness and pain.
A hyaluronic acid knee injection adds a gel similar to your body’s own joint fluid. That’s why viscosupplementation is often called a gel injection for knee pain. It doesn’t regrow cartilage, but it may improve the joint’s cushioning and lubrication and reduce pain for a period of time.
Different hyaluronic acid products are given as a single injection or as a series of weekly injections.
Knee viscosupplementation is used mainly for:
that causes pain with walking, stairs or standing
that hasn’t improved enough with physical therapy, weight management or over-the-counter pain relievers
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or who want to limit repeated steroid injections
Learn about Neck Pain
For a broader look at knee pain causes and options, see our knee pain guide or compare other knee injectionsÂ
A facet joint injection may be considered if:
You may be a candidate if you have confirmed knee osteoarthritis and ongoing pain despite other conservative treatments. Viscosupplementation may be less helpful in very advanced arthritis. It may not be appropriate if you have a knee infection, a skin condition over the knee or an allergy to the product ingredients
Your provider will review your imaging and history to decide whether it’s a reasonable option.
Your provider confirms the diagnosis and discusses how many injections your treatment involves. Let your provider know about blood thinners and allergies.
The knee is cleaned and may be numbed. If the joint is swollen, excess fluid may be removed first. The viscosupplementation injection is then given into the joint, sometimes with ultrasound guidance
You’ll likely be advised to avoid strenuous activities, such as running or heavy lifting, for about 48 hours. Normal walking is usually fine.
Relief from viscosupplementation isn’t immediate. Many people notice changes over several weeks after the injection or the full series. When it helps, relief may last for months, and the treatment can sometimes be repeated. Results vary, and not everyone responds.
Pairing injections with strengthening exercises may help support the knee over time.
Side effects are usually mild and short-lived, such as pain, warmth or swelling at the injection site. Occasionally, a temporary flare of pain and swelling can occur. Infection is rare. Contact our office if you notice increasing redness, heat or fever.
Call our office if you notice increasing redness, heat or swelling in the knee, pain that keeps getting worse, or a fever.
Seek emergency care right away if you have a fever with chills, a rapidly swelling hot joint, or trouble breathing.
Many plans, including Medicare, may cover viscosupplementation for knee osteoarthritis when certain criteria are met, such as imaging evidence and documentation of prior treatments. Our team can help you check your benefits.
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A cortisone shot reduces inflammation and may work within days. A hyaluronic acid knee injection supplements joint fluid, tends to work more gradually and may provide relief for a longer period in some people.
It depends on the product. Some are a single injection, and others are given weekly for several weeks.
For some people with mild to moderate arthritis, it may help manage symptoms and delay the need for surgery. It doesn’t reverse arthritis, and results vary.
It’s used mainly for the knee.
Schedule an evaluation at our Rego Park, Queens office to find out whether viscosupplementation may be right for your knee.
