Knee Gel Injections for Osteoarthritis: The Best Products and Procedures

Knee Treatments


Last Updated On: 2024-01-12

We explore HA injections as one of the popular options for knee arthritis treatment to help you make informed product decisions, relieve your patients’ symptoms, and grow your practice.

Doctor Medica team

Osteoarthritis significantly impairs a person’s quality of life because it is accompanied by severe pain and limitation of joint function. Since it is a progressive disease, in the absence of treatment (or in case of incorrect treatment), it can often lead to disability.

The importance of this problem becomes especially clear in the example of osteoarthritis of the knee joint, one of the most common pathologies among the diseases with the highest contribution to global disability. So, it is obvious that the prevention and treatment of this disease is a serious concern for doctors worldwide.

Knee Gel Injections – Mechanism of Action

Knee gel injections, also known as viscosupplementation, involve the introduction of a gel-like substance directly into the knee joint, aiming to improve lubrication, reduce friction, and alleviate pain and stiffness commonly associated with OA.

The effectiveness of these injections lies in the unique properties of the substances used. The products for viscosupplementation contain hyaluronic acid, a naturally occurring molecule found in joint synovial fluid. HA plays a crucial role in joint lubrication and shock absorption, alleviating pain and improving joint function.

Indications for knee injection gel therapy:

  • Osteoarthritis (arthrosis) of the knee joint;
  • Pain and discomfort in the knees;
  • Restriction of movement in the knee joint.

However, careful patient selection for the treatment is essential. The procedure should be postponed or canceled in the following cases:

  • Allergy to hyaluronic acid;
  • Exacerbation of inflammatory diseases;
  • Severe stage of osteoarthritis;
  • Pregnancy and lactation.

Products Used for Knee Arthritis Viscosupplementation

There is a wide assortment of hyaluronic acid formulations available on the market, each with unique characteristics. To help you make the best choice for your patients, let’s explore several prominent brands and consider the main factors for product selection:

  • The first crucial factor to weigh when choosing a hyaluronic acid product is its molecular weight. Higher molecular weight hyaluronic acid formulations, like Synvisc, Orthovisc, and Euflexxa, are known for their increased viscosity and durability within the joint, often translating to longer-lasting relief for patients.
  • The concentration of hyaluronic acid can vary significantly between products. For example, Orthovisc, Supartz, and Hyalgan offer highly concentrated formulations. These elevated concentrations can provide more immediate relief, benefiting patients seeking rapid pain reduction. However, higher concentrations can significantly increase the risk of side effects.
  • Cross-linking of the formulations is also an essential factor. Some products, like Synvisc, Gel-One, and Monovisc, are cross-linked, so they can result in longer-lasting relief for patients who prefer fewer injections over time. However, balancing this advantage with potential knee gel injections’ side effects and patient preferences is essential.

When making a final decision, you should also consider factors such as ease of administration, patient comfort, and your familiarity with the product.

Benefits of Knee HA Injections

Knee injections for arthritis have several notably positive effects on OA patients:

  • Pain relief that allows patients to regain mobility and enjoy a better quality of life.
  • Enhanced lubrication and reduced friction within the joint can lead to improved joint function and increased range of motion.
  • Many patients experience reduced joint stiffness, allowing for more effortless movement and less discomfort.
  • Minimal side effects, including temporary swelling and mild discomfort at the injection site, are generally well-tolerated and transient.

The Treatment Procedure

Knee gel injections are typically administered in an outpatient setting. The procedure involves several steps:

  1. A comprehensive assessment of the patient’s medical history, OA severity, and suitability for knee gel injections. Educate patients about the possible side effects: they are generally mild and temporary and can include pain, swelling, and mild joint effusion.
  1. Preparation of the injection site by cleaning and sterilizing the area around the knee.
  1. Administration of the hyaluronic gel, guiding the needle directly into the joint space under ultrasound supervision.
  1. Advising the patient on post-injection care, including any restrictions on activities and the potential side effects of the procedure.
  1. Scheduling follow-up appointments to monitor the patient’s progress and determine the need for additional injections. Typically, a series of injections is administered over several weeks.

To provide quality care tailored to each patient’s needs, you must be aware of alternative treatment options, including pharmaceuticals, physical therapy, and surgical interventions.

Alternative Treatment Methods for Osteoarthritis

In addition to hyaluronic acid injections in the knee, several alternative treatments can complement or serve as alternatives to viscosupplementation for managing OA:

  • Physical therapy – exercise programs and modalities can improve joint strength and mobility while reducing pain.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics can relieve pain, especially for mild to moderate OA.
  • Intra-articular corticosteroid injections offer short-term pain relief and anti-inflammatory effects.
  • Lifestyle modifications like weight management, low-impact exercise, and joint protection techniques.
  • Surgical interventions such as knee arthroscopy or joint replacement may be necessary in advanced cases.
  • Regenerative therapies like platelet-rich plasma (PRP) and stem cell therapy can promote tissue healing and regeneration.
  • Nutritional supplements like glucosamine and chondroitin sulfate, but their results can vary.


Knee viscosupplementation has become an integral component of osteoarthritis management, providing pain relief, improved joint function, and enhanced quality of life for many people, especially those looking to improve joint function without more invasive treatments like surgery.

However, the choice between the injection products should be based on patient factors and preferences and combined with other treatment options for better effect.

Adding knee gel injections to your patients’ treatment plans can contribute to the growth of your practice while ensuring patients receive comprehensive and effective care.


What is the best injection for osteoarthritis of the knee?

There is no single best knee osteoarthritis injection. The decision should be made after assessing each patient’s condition, preferences, and goals for treatment.

Synvisc and Orthovisc are well-established brands among hyaluronic acid injections, but several other options are also available. Many orthopedic doctors have had positive experiences with various products, and patient-specific factors should guide your product selection.

How long do gel injections for knees last?

The duration of knee gel injections’ effects varies from patient to patient and depends on several factors:

  • The product used;
  • Individual response;
  • The severity of OA and joint damage;
  • The patient’s activity level and adherence to post-injection care recommendations.

Typically, patients can expect relief to last anywhere from several months to over a year. Regular follow-up appointments can help assess the need for additional injections to maintain symptom relief.

Do gel shots help arthritic knees?

Here’s how viscosupplementation can help with arthritic symptoms, particularly in individuals with osteoarthritis (OA):

  • The gel substance acts as a lubricant and shock absorber within the joint, reducing friction and pain during movement and alleviating pain and discomfort associated with knee osteoarthritis.
  • Gel shots supplement the natural synovial fluid, enhancing joint lubrication and promoting smoother movement.
  • Many individuals with arthritic knees experience improved joint function and increased range of motion following gel shot injections.

However, while gel shots can be helpful in managing knee osteoarthritis, their effectiveness varies from person to person. Some individuals may experience more substantial relief than others, and individual responses to treatment may differ.

In some cases, HA shots may be recommended as part of a comprehensive treatment plan that includes other interventions like physical therapy, lifestyle modifications, or medications.


Peck J, Slovek A, Miro P, et al. A comprehensive review of viscosupplementation in osteoarthritis of the knee. Orthopedic Reviews. 2021;13(2). doi:10.52965/001c.25549.

Webner D, Huang Y, Hummer CD. Intraarticular hyaluronic acid preparations for knee osteoarthritis: Are some better than others? Cartilage. 2021;13(1_suppl):1619S-1636S. doi:10.1177/19476035211017320.

Pereira T, Jüni P, Saadat P, et al. Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis. BMJ. July 2022:e069722. doi:10.1136/bmj-2022-069722.

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