Hyaluronic Acid Injections

To treat

Cartilage damage and mild to moderate arthritis pain. Also an option for patients hoping to delay or avoid joint replacement. Can sometimes help with pain relief in advanced arthritis whilst waiting for joint replacement or in patients who cannot proceed to joint replacement for whatever reason. We use HA injections as a better alternative to a steroid injection. We do not recommend steroid injections for arthritis as these can make arthritis worse.


Hyaluronic acid (HA) is a normal component of the fluid in hip and knee joints and helps to cushion the joint cartilage and lubricate the joint. In osteoarthritis (wear and tear arthritis) the joint deteriorates and the levels of HA go down. HA injections restore the level of HA so that the joint is protected once more and have a natural anti-inflammatory effect and reduce pain.

The injection is performed with strict sterile technique under ultrasound guidance. Local anaesthetic is used to make the injection virtually pain-free. Excess joint fluid is removed and then the hyaluronic acid is injected. It is a walk in walk out procedure done in the outpatient clinic. Most patients notice an improvement in their pain starting about 2 weeks after the injection. Some notice pain relief much earlier. The improvement can last for up to 6-9 months and for even longer in some patients. If successful, the injection can be repeated when the effect wears off.


Complications are rare. Standard risks apply. Infection. Slight soreness after the injection. Reactions to the injection are almost never seen in our practice as we use non-animal derived HA.


No special preparation is required.

Appointment Duration

20-30 minutes

Recommended Number

We perform one injection initially and repeat it if and when the effect begin to wear off. In some patients who have a good, but short-lived response, we recommend a course of 3 injections over a period of approximately 6-8 weeks. We have found that the 3 injection regime also works better in those with very advanced arthritis.


A showerproof dressing is applied. This should be left in place for 24 hours. Normal activity is allowed after the injection without restriction.



    Studies have confirmed that HA injections can delay the need for knee replacement surgery for an average of 3 years.


    The results are mixed, with some showing a significant benefit and others showing little benefit over a steroid injection. The problem with the studies may relate to the fact that there are many different types of HA and the benefit may vary depending on the type used. The different types vary in the molecular weight and concentration of the HA and whether the HA is animal-derived or synthetic. Higher molecular weight HA is thicker and offers more shock absorbing properties.


    We use HA injections as an alternative to steroid injections as the latter can have harmful effects in arthritic joints. We use a synthetic HA with a very high molecular weight and concentration. We have found that virtually all patients derive benefit from HA injections, but that the duration and magnitude of the benefit varies significantly. Some get a good benefit for a few weeks, others get a smaller benefit for longer. There is also a group of clients who benefit strongly for 9-12 months. Unfortunately it is impossible to predict who will benefit the most. We have observed that the severity of arthritis does not affect the outcome of HA injections.


    There is less research about this. We have found that HA works well in a group of patients, but not as well as it does with knee arthritis. We have found it useful in patients with severe pain awaiting hip replacement where it makes the pain much more bearable in many cases.

Case Stories

This single treatment has removed all pain from the knee, and I am able to swing my golf clubs and walk freely again. It may be necessary to have another injection some time in the future but I would not hesitate to do it again.

I would certainly recommend my friends to consider this as a much preferred alternative to surgery or steroid injections.

I was finding walking, climbing stairs and driving extremely painful. After several diagnoses I was told I needed a knee replacement. After a consultation with Mr Sood it became clear that was not my only option. I find him extremely professional, he is friendly and really listens. I have complete faith in his expertise and felt involved in the whole process. I opted for a viscossupplementation injection which gave me over a year of pain relief and the ability to get on with daily life. I highly recommend Mr Sood you are in good hands.