Hyaluronic Acid Injection for Osteoarthritis of the Knee

Hyaluronic Acid Injection for Osteoarthritis of the Knee

Many people suffer from osteoarthritic changes (normal age related wear and tear changes) in the knee. This can be very debilitating, and particularly for people who are keen on exercise this can prevent them from taking part in activities they enjoy such as walking, jogging, playing tennis. As well as impacting on a whole range of hobbies and activities osteoarthritis of the knees can significantly disrupt normal day to day living and quality of life.

Why have hyaluronic acid injection rather than steroid injection

Hyaluronic acid may be favoured by some patients for a range of reasons. Some patients are not able to have steroid injections for medical reasons. Some patients may only experience short lived relief from steroid injections. Also, we have to observe limits on the number of steroid injections that a patient can have (we normally recommend no more than three injections per year into the same joint), otherwise the steroid injection may eventually cause a detrimental effect to the soft tissue and joint.


However, hyaluronic acid offers a significantly different option and may be a viable solution for maintaining comfort in the knee especially for patients who are active. They work in a very different way to steroid injections in that they help to replenish and nourish the joint (steroids work as they are potent anti-inflammatories). There is some evidence they may even be able to slow down the progression of osteoarthritis (wearing of the joint) as part of an overall maintenance program including strengthening, weight management and activity modification.


How do hyaluronic acid injections work:

Hyaluronic acid is based upon a naturally occurring substance within all joints of the body. This substance helps to give nourishment to the joint. There is some suggestion that it may provide some kind of cushioning effect within the joint and it also appears to have some sort of direct pain relieving effect within the tissue, possibly by a blockade of nerve endings, which are otherwise being noxiously stimulated.


Who are hyaluronic acid injections most appropriate for?

We are able to offer hyaluronic acid injections for a whole range of patients. Some patients who are quite young and active but are experiencing early osteoarthritic pain through repeated impact activity such as jogging. We also use it for patients with quite significant levels of osteoarthritis who are wishing to remain active and are keen to prolong the functionality of the joint in the best possible way for as long as possible. Some patients opt for hyaluronic acid because of medical or other reasons they are unable to have steroid injections or joint replacement surgery.


How do I know if hyaluronic acid injection is appropriate for me?

This may be discussed with your GP or orthopaedic consultant. You are very welcome also to contact one of our team of expert clinicians via injections@complete-physio.co.uk who will always be very happy to answer any queries that you may have. Our team has vast experience in the use of hyaluronic acid (along with the full range of assessment and treatments for osteoarthritis)  and therefore will be able to guide you as to whether or not this treatment is appropriate for you.


Ostenil Plus 40mg/2mls £260 per injection

Durolane 60mg/3mls £350 per injection

All injections are performed under ultrasound guidance and the fee is all inclusive for assessment, injection and written report.

If you require any further information, please do not hesitate to contact us:

Telephone: 0207-482-3875

Email:  injections@complete-physio.co.uk


Research Articles of Interest

Bannuru, R.R., Natov, N.S., Dasi, U.R., Schmid, C.H. and McAlindon, T.E., 2011. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis–meta-analysis. Osteoarthritis and cartilage19(6), pp.611-619.

Bannuru, R.R., Natov, N.S., Obadan, I.E., Price, L.L., Schmid, C.H. and McAlindon, T.E., 2009. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: A systematic review and meta‐analysis. Arthritis Care & Research61(12), pp.1704-1711.

Colen, S., van den Bekerom, M.P., Mulier, M. and Haverkamp, D., 2012. Hyaluronic acid in the treatment of knee osteoarthritis. BioDrugs26(4), pp.257-268.

Huskisson, E.C. and Donnelly, S., 1999. Hyaluronic acid in the treatment of osteoarthritis of the knee. Rheumatology (Oxford, England)38(7), pp.602-607.

Wen, D.Y., 2000. Intra-articular hyaluronic acid injections for knee osteoarthritis. American family physician62(3).