MONOVISC®

How MONOVISC® Works — Ultra-Pure HA and the Viscosupplementation Mechanism

In osteoarthritis, the concentration and viscoelastic quality of hyaluronic acid in synovial fluid may decline, reducing the knee joint’s ability to absorb load, resist friction, and move comfortably. MONOVISC® works by supplementing this naturally occurring HA — delivered as a single intra-articular injection directly into the knee joint — to help restore the lubricating and cushioning properties that osteoarthritis depletes. [2][4]

The formulation uses non-animal, bacterial fermentation-derived hyaluronic acid that is cross-linked and highly purified. Anika Therapeutics describes the product as “ultra-pure HA” as part of its brand positioning, reflecting the formulation’s non-animal source and controlled manufacturing process. This characteristic distinguishes MONOVISC® from avian-derived viscosupplements, and that may be clinically relevant when evaluating source and tolerability in sensitive patients. The cross-linked structure is designed to support durability and residence time within the joint. [2][4]

A question practitioners encounter frequently from patients: is MONOVISC® a steroid? No. MONOVISC® is a hyaluronic acid medical device. It works through viscosupplementation, not through the anti-inflammatory pathway of corticosteroids. This distinction matters both for patient consent and for clinical planning when considering MONOVISC® alongside or instead of corticosteroid injections. [2]

The single-injection format is what most clearly sets MONOVISC® apart from multi-injection viscosupplements. One intra-articular injection per treatment cycle reduces clinic visits, simplifies scheduling, and may improve patient compliance for those who find it difficult to commit to a 3–5 week injection series. For practitioners comparing single-injection convenience with staged dosing protocols, MONOVISC® and its high-dose 88 mg/4 mL formulation represent a clinically meaningful alternative, supported by randomized controlled trial evidence. [1][2][4]

Clinical evidence includes a multicenter, double-blind, randomized, placebo-controlled trial that used the Western Ontario and McMaster Universities Osteoarthritis Index and reported clinically meaningful improvement in knee pain from baseline within 2 weeks in symptomatic knee OA patients receiving a single intra-articular injection of lightly cross-linked hyaluronic acid. [1]

MONOVISC® Product Spotlight

MONOVISC® 88 mg/4 mL is supplied as a single-use prefilled syringe containing 4 mL of cross-linked, high-molecular-weight hyaluronic acid at a concentration of 22 mg/mL. It delivers a total dose of 88 mg per treatment. The HA is derived through bacterial fermentation, making it a non-avian product, and the formulation is suspended in phosphate-buffered saline. [2][4]

MONOVISC® is designed for osteoarthritis sufferers who want knee pain relief from a single clinic visit rather than a multi-week injection course. Its 4 mL volume makes it one of the higher-volume single-injection viscosupplements available, and its shared technology base with ORTHOVISC® gives practitioners a familiar clinical reference point when evaluating the product for the first time. [2][4]

Practitioners preparing to buy MONOVISC® injection online should verify the product format, LOT number, expiry, storage requirements, and available documentation before clinical use. Because MONOVISC® is a single-SKU brand in this category, this page spotlights the 88 mg/4 mL syringe in depth rather than listing multiple dosage variants. [2]

Treatment Areas and Patient Indications

MONOVISC® is indicated for pain associated with osteoarthritis of the knee in patients who have not responded adequately to conservative non-pharmacologic therapy or simple analgesics. The target patient is one seeking non-surgical knee pain relief — particularly those who prefer or benefit from a single-injection option rather than a multi-visit treatment series. [2]

The FDA-approved indication covers the knee joint. Some clinical literature and international market references discuss viscosupplementation in the hip, shoulder, and ankle, but these fall outside MONOVISC®’s approved US labeling and should be assessed against local regulations, available clinical evidence, and individual patient circumstances before consideration. [2]

Because MONOVISC® is an orthopedic hyaluronic acid injectable, it belongs to a different clinical and regulatory category from aesthetic HA products used for soft-tissue correction or facial volumization. Practitioners building a broader injectable practice can explore the Doctor Medica catalog for viscosupplementation options before they buy orthopedic injections, while those seeking aesthetic HA products can review separate categories. Practitioners who buy dermal fillers or buy HA dermal fillers are working with an entirely different product class.

Administration, Dosing, and Aftercare

MONOVISC® is administered as a single intra-articular injection into the knee joint by a licensed practitioner, using strict aseptic technique. Each prefilled syringe delivers 88 mg of hyaluronic acid in 4 mL and constitutes one full treatment cycle for one knee. If both knees require treatment, a separate syringe must be used for each. [2]

Before administration, the knee should be assessed for swelling, tenderness, or joint effusion. If excess fluid is present, aspiration, at the practitioner’s discretion, may be performed prior to injection to ensure accurate placement and patient comfort. MONOVISC® should not be injected into an infected joint or through skin affected by active infection or disease. [2]

How Long Before MONOVISC® Starts Working?

Onset varies by patient. Published RCT data report clinically meaningful knee pain reduction within two weeks in some patients, while others experience more gradual relief as their knees respond to viscosupplementation. Individual results depend on OA severity, joint condition, and patient factors. [1]

MONOVISC® injection recovery time is generally brief. Patients are typically advised to avoid strenuous or prolonged weight-bearing activities (such as running, tennis, or heavy lifting) for approximately 48 hours after injection. Most patients return to normal daily activities within 1 to 2 days, though temporary soreness, swelling, or stiffness at the injection site may occur during that period. [2]

Regulatory Status and Medicare Coverage

MONOVISC® is FDA-approved for pain associated with osteoarthritis of the knee in patients who have not had adequate relief from conservative non-drug therapy or simple analgesics. It is regulated as a Class III medical device under PMA #P090031 and is administered by or on the order of a licensed physician. [2]

Medicare Coverage

Coverage may apply under applicable CMS viscosupplementation criteria when medical necessity and documentation requirements are met. CMS guidance for hyaluronic acid knee injections generally requires a confirmed diagnosis of symptomatic knee OA, documented failure or contraindication to conservative therapy, and adherence to FDA-approved dosing and frequency. [3]

For billing, MONOVISC® is associated with HCPCS code J7327, listed by CMS as hyaluronan or derivative, MONOVISC®, for intra-articular injection per dose. Clinics should verify current CPT coding, site modifiers, payer requirements, and local coverage determination policies before submitting claims, as billing practices may vary by region and payer. [3]

About MONOVISC® — Clinical Positioning and the Anika Therapeutics Portfolio

MONOVISC® is manufactured by Anika Therapeutics, a US-based global medical technology company headquartered in Bedford, Massachusetts, focused on joint preservation and regenerative medicine. Its orthopedic viscosupplementation portfolio includes MONOVISC®, ORTHOVISC®, and CINGAL®, establishing the company’s depth of experience in hyaluronic acid-based knee OA treatment. [4]

Within that portfolio, MONOVISC® and ORTHOVISC® are closely related: both use Anika’s proprietary HA platform, but ORTHOVISC® is administered as a 3–4-injection course, while MONOVISC® delivers the full treatment in a single visit. This gives practitioners and patients a choice between formats from a single manufacturer with a consistent technology base. Clinics preparing to order MONOVISC® or purchase MONOVISC® for their orthopedic offering should review the manufacturer’s IFU, FDA documentation, storage requirements, and local regulatory requirements before clinical use. [2][4]

MONOVISC® Safety Profile — Side Effects and Contraindications

The safety profile of MONOVISC® is broadly consistent with other intra-articular hyaluronic acid viscosupplements. Because the product is administered directly into the knee joint, the vast majority of reported adverse events are localized to the injection site or the treated joint rather than systemic. [2]

Common Side Effects

Most local reactions are transient and typically resolve within a matter of days. Licensed practitioners should advise patients to anticipate mild, temporary symptoms around the treated area, including: [2]

• Localized pain or tenderness at the injection site
• Joint swelling, stiffness, or effusion
• Warmth or erythema (redness)
• Mild localized inflammation

Clinical Note: While acute, severe local joint reactions are uncommon after viscosupplementation, patients must be instructed to promptly report persistent pain, marked swelling, fever, or any potential signs of infection for immediate clinical evaluation. [2]

Contraindications & Patient Screening

Before scheduling a treatment cycle, practitioners must review the patient’s medical history against the following established contraindications and safety parameters: [2]

• Hypersensitivity: Contraindicated in patients with known allergies to hyaluronate preparations or gram-positive bacterial proteins.
• Active Infection: Do not inject into an infected knee joint or through skin affected by active localized infection or dermatological disease.
• Bleeding Disorders: Contraindicated in patients diagnosed with known systemic bleeding disorders or those on therapeutic anticoagulation where intra-articular injection is unsafe.
• Unestablished Populations: Safety, efficacy, and dosing have not been established in pregnant women, lactating mothers, or pediatric patients.

Proper patient screening, strict aseptic technique, and brief post-injection monitoring remain essential clinical practices, regardless of the patient’s historical tolerance to other intra-articular or orthopedic injectables. [2]

MONOVISC® vs Competing Viscosupplements

vs ORTHOVISC®

MONOVISC® and ORTHOVISC® share the same manufacturer and the same proprietary HA technology platform. The defining difference is the treatment schedule: MONOVISC® is given as a single injection per cycle, while ORTHOVISC® requires 3–4 weekly injections. For practices that offer both, patients can be matched to the format that suits their preference and compliance profile — clinics that buy ORTHOVISC® alongside MONOVISC® can cover both single-visit and multi-injection needs without changing manufacturer.

vs SYNVISC®

MONOVISC® is a non-avian, bacterial fermentation-derived cross-linked HA, while SYNVISC® uses avian-derived cross-linked hylan G-F 20. Both products have a single-injection option — MONOVISC® and SYNVISC-ONE®, respectively — but they differ in HA source, molecular structure, and clinical profile. For practices that stock both formats, those who buy SYNVISC® have an avian-derived alternative available for cases where the cross-linked hylan formulation is preferred.

vs EUFLEXXA®

MONOVISC® and EUFLEXXA® are both non-avian HA viscosupplements, but their treatment schedules differ significantly. MONOVISC® delivers the full dose in one injection, while EUFLEXXA® is administered as a three-injection weekly series. The comparison is primarily one of convenience versus staged dosing — practices that buy EUFLEXXA® can offer patients a non-avian HA option within a three-week protocol, complementing MONOVISC® for cases where a single-visit approach is not preferred.

vs HYALGAN®

MONOVISC® is a single-injection, non-avian, cross-linked HA product that delivers 88 mg in a single visit. HYALGAN® is an avian-derived sodium hyaluronate administered as a labeled five-injection weekly course, with some clinical data also supporting a three-injection schedule. The comparison covers injection frequency, HA source, molecular characteristics, and considerations for avian allergy. Practices that buy HYALGAN® maintain a multi-injection avian HA option for patients and payers where that protocol is preferred or required.

vs SUPARTZ®

MONOVISC® offers single-injection convenience with a non-avian HA source, while SUPARTZ® is an avian-derived sodium hyaluronate administered over a 3–5-injection course. For practices evaluating the two, the decision typically comes down to injection frequency, avian allergy screening requirements, and payer familiarity with each product’s billing code. Clinics that buy SUPARTZ® can position it as a multi-injection avian HA complement to MONOVISC®’s single-visit format.

vs Durolane

MONOVISC® and Durolane are both single-injection viscosupplements for knee osteoarthritis, and both are non-animal-derived HA products — a key clinical similarity that sets them apart from avian-derived competitors. Where they differ is in cross-linking technology, molecular characteristics, and clinical evidence base. For practitioners choosing between single-injection non-avian options, the comparison typically centers on payer access, local product availability, and each product’s specific RCT data.

Doctor Medica has supplied viscosupplementation and orthopedic injection products to licensed practitioners for over 20 years, offering competitive wholesale prices, guaranteed authenticity, and verifiable LOT numbers. Licensed practitioners looking to buy MONOVISC® online, buy MONOVISC® wholesale, order MONOVISC®, or purchase MONOVISC® can browse the Doctor Medica catalog or contact representatives for availability, documentation, and product support.

FAQs

What is MONOVISC®?

MONOVISC® is an FDA-approved single-injection hyaluronic acid viscosupplement by Anika Therapeutics. It contains 88 mg of cross-linked HA in 4 mL for intra-articular treatment of knee osteoarthritis pain, administered as one injection per treatment cycle. [2]

Is MONOVISC® a one-time injection?

Yes. MONOVISC® is administered as a single intra-articular injection in the knee per treatment cycle, distinguishing it from multi-injection viscosupplements such as ORTHOVISC® (3–4 injections), HYALGAN® (five-injection labeled cycle), and SUPARTZ® (3–5 injections). [2]

How does MONOVISC® work?

MONOVISC® supplements the hyaluronic acid naturally present in synovial fluid, helping restore the knee joint’s lubricating and cushioning properties depleted by osteoarthritis. It is a hyaluronic acid medical device, not a steroid. [2][4]

Is MONOVISC® a steroid?

No. MONOVISC® is not a corticosteroid. It is a hyaluronic acid viscosupplement classified as a medical device, used for intra-articular knee injection. [2]

How long does it take for MONOVISC® to work?

No. MONOVISC® is not a corticosteroid. It is a hyaluronic acid viscosupplement classified as a medical device, used for intra-articular knee injection. [2]

How long do MONOVISC® side effects last?

Common injection-site reactions such as pain, swelling, or warmth are generally transient and typically resolve within a few days. Persistent pain, significant swelling, fever, or signs of infection should be evaluated by a clinician. [2]

Does Medicare cover MONOVISC®?

Coverage may apply under applicable CMS viscosupplementation criteria for eligible patients with knee osteoarthritis. Coverage depends on medical necessity documentation, diagnosis confirmation, and payer-specific requirements. Clinics should verify patient-specific coverage before treatment. [3]

MONOVISC® vs ORTHOVISC® — what is the difference?

Both are Anika Therapeutics HA viscosupplements using the same proprietary platform. MONOVISC® is a single-injection product while ORTHOVISC® requires 3–4 injections per cycle. The choice depends on patient preference, compliance, and clinic workflow. [2][4]

MONOVISC® vs SYNVISC® — how do they compare?

MONOVISC® is a non-avian, bacterial fermentation-derived cross-linked HA product. SYNVISC® uses avian-derived cross-linked hylan G-F 20. Both have single-injection options, but they differ in their HA sources, structures, and clinical profiles. [2]

Where can practitioners buy MONOVISC® wholesale?

Licensed practitioners can buy MONOVISC® through Doctor Medica, which supplies orthopedic injectables at wholesale prices with verifiable LOT numbers and documentation support. Contact representatives for product availability and professional purchasing assistance.

Citations

1. Petterson SC, Plancher KD. Single intra-articular injection of lightly cross-linked hyaluronic acid reduces knee pain in symptomatic knee osteoarthritis: a multicenter, double-blind, randomized, placebo-controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy. https://pubmed.ncbi.nlm.nih.gov/30159738/
2. S. Food and Drug Administration. Premarket Approval (PMA) — MONOVISC (P090031). FDA. Last Updated 06/22/2026. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?ID=P090031S003
3. Centers for Medicare & Medicaid Services. Billing and Coding: Intraarticular Knee Injections of Hyaluronan (Article A56157). CMS. Last Updated 06/18/2026. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56157
4. Anika Therapeutics. FDA Approves MONOVISC®, A New Single Injection Treatment for Treatment of Pain Due to Osteoarthritis of the Knee. Anika Therapeutics press release. 2014. https://ir.anika.com/FDA-Approves-MONOVISC-R-,-A-New-Single-Injection-Treatment-for-Treatment-of-Pain-Due-to-Osteoarthritis-of-the-Knee

For licensed medical professionals only. This content is for informational purposes only and does not constitute medical advice.