In patients suffering with Osteoarthritis of knee joint, the cartilage lining  protecting the ends of bones gradually wears off, reduction in quantity of joint fluid (Synovial fluid), and bone ends rub against each other – all of which can cause the pain.

The usual complaints are pain,stiffness, grinding sensation, swelling in and around the knee. Sometimes there is difficulty in walking for short distances and locking symptoms.

Osteoarthritis of knee can be graded / staged based amount of damage to cartilage lining. An X- ray can be useful in staging osteoarthritis of knee. It’s not only the grade but level of pain had to considered before starting a treatment.

What is Hyaluronic acid?

Hyaluronic acid is a visco-supplementation injection that lubricates and cushions your joint. It can provide pain relief in Osteoarthritic knee up to nine months to two years with just one injection. Patients with knee Osteoarthritis who have tried diet,exercise but still have pain can get benefit from this injection. The main aim of giving Hyaluronic acid injections is to decrease pain and improve functions in patients with joint pain. Hyaluronic acid injections have been shown to have the following beneficial effects on joints:

  1. They replace some of the normal ingredients found in the synovial fluid improving the lubricating ability.
  2. They help to stimulate the joint lining (the synovium) manufacture more normal synovial fluid.
  3. The Hyaluronic acid coats the lining of damaged joint surfaces, covering pain nerve endings. This reduces pain and protects the joint surfaces from joint inflammation.
  4. Hyaluronic acid also acts directly to reduce inflammation in a joint, like steroid.

How is Hyaluronic acid given?

It comes as a single injection as sterile pack from the manufactures. It is administered by intra-articluar route (directly into the knee joint). It’s a simple out- patient procedure that only takes a few minutes. You can continue with day to day normal activities after the injection. Try to avoid strenuous activities for about 48 hours.


-  It is done in outpatient department in clean dressing room or sometimes in minor operation theater.

-  Doctor prepares the knee by cleaning it with Iodine solution.

-  Give local anesthesia.

-  Sometimes doctor may aspirate excess fluid inside the joint.

-  He then injection into the joint directly

-  You can walk out immediately after the procedure.

Frequently asked questions?

1. What you can expect following a hyaluronic acid injection?

Hyaluronic acid can provide pain relief upto nine months to two years.

2. Will the injection be painful?

Since the injection is given through small needle and directly into the joint there wouldn’t be severe pain. Sometimes doctor can give local anaesthesia to numb the area before giving injection.

You may feel mild pain and swelling of knee after injection which is normal.  Place an ice pack on your knee for 10 min at regular intervals.

3. What happens after the injection?

During the first couple of days-

Return to normal day to day activities.

Avoid strenuous activities such as jogging lifting weights for first 48 hours.

During following months –

The intensity of osteoarthritic pain comes down and pain relief varies from patient to patient. The benefits of injection can last for 9 months to 2 years depending on stage of osteoarthritis, vary with patients.

These injections can be repeated safely.

4. What are the side effects of injection?

Before taking the injection you should inform your doctor about any allergic reactions to Hyaluronan products or avian proteins (Chicken).  Some side effects are mild and temporary like

Allergic reactions, pain, swelling, stiffness.

There are chances of getting knee joint infection in rare cases.