Rebecca J. Stahl, MA
Viscosupplementation is an injection of a fluid called hyaluronic acid into the knee joint.
This injection is used to treat the symptoms of
Healthy joints contain synovial fluid. This fluid lubricates and provides nutrients to the joints. One change that happens with OA is the synovial fluid becomes thinner and less useful as a lubricant for the joint.
With viscosupplementation, hyaluronic acid, which is found in synovial fluid, is injected into the knee joint. This makes the synovial fluid act as a better lubricant. It is hoped that this will reduce pain and improve function of the joint. In some cases, getting this injection may help to postpone surgery on the knee joint.
Viscosupplementation may be a good option if you have tried other types of treatment and these have failed.
Potential problems are rare. But, all procedures have some risk. Your doctor will review potential problems, like:
These factors reduce the chance that viscosupplementation will be effective for you:
Before getting this injection, your doctor will most likely have you try many other ways to treat OA, such as:
If these methods are not helpful, then viscosupplementation may be a good option for you. Before the injection, your doctor may:
If you are taking any prescription medications, over-the-counter products, or herbs and supplements, talk to your doctor. There could be an interaction with the injection.
First, your doctor will clean the skin where the needle will be inserted. A local anesthetic may be applied to numb the area. If you have swelling in the knee joint, the doctor will use a needle to remove the excess fluid. Next, a needle will be used to inject the hyaluronic acid into the joint. If needed, both knees can be done at the same appointment.
While your schedule for receiving injections will vary depending on the brand, you may have a cycle of three injections (eg, on days 1, 8, and 15) or just one. You may need to go through injections more than once. In some cases, it can relieve pain for months to years.
The procedure usually takes a few minutes to do.
You may feel the prick of the needle. Right after the injection, you may have some mild pain, warmth, and swelling around the knee joint.
When you return home after the procedure, do the following to help ensure a smooth recovery:
As you go through the injection cycles, you may have:
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
American Chronic Pain Association
Ortho Info—American Academy of Orthopaedic Surgeons
The Arthritis Society
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Degenerative joint disease of the knee. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated February 15, 2011. Accessed February 23, 2011.
Divine JG, Zazulak BT, et al. Viscosupplementation for knee osteoarthritis: A systematic review.
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Joint aspiration and injection. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/services/services/hic_joint_aspiration_and_injection. Accessed February 24, 2011.
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http://orthoinfo.aaos.org/topic.cfm?topic=a00217. Updated February 2009. Accessed February 23, 2011.
Last reviewed December 2014 by Michael Woods, MD
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