What is viscosupplementation with hyaluronic acid?

Viscosupplementation with hyaluronic acid is a treatment for symptoms of osteoarthritis. Natural hyaluronic acid helps lubricate and cushion joints. People with osteoarthritis have less hyaluronic acid in their joint fluid than normal. Viscosupplementation with hyaluronic acid involves injecting synthetic joint lubricant into the affected joint. This can help reduce inflammation and pain in joints, such as the knee, hip, shoulder and wrist.

Viscosupplementation does not cure osteoarthritis but can reduce symptoms, including inflammation and pain. Viscosupplementation may also signal the body to produce more of its own natural hyaluronic acid. Viscosupplementation is only one method used to treat osteoarthritis. Discuss all of your treatment options with your doctor to understand which options are right for you.  

Other procedures that may be performed

Your doctor will likely recommend one or more complementary treatments or lifestyle modifications along with viscosupplementation with hyaluronic acid. These can include physical therapy, exercise, or assistive devices such as braces or canes. Recommendations will vary depending on the extent of your joint’s deterioration, your age, your symptoms, and other factors. 

Why is viscosupplementation with hyaluronic acid performed? 

Doctors most frequently use viscosupplementation to treat osteoarthritis in the knees. They also use it to treat symptoms in other joints, such as the hip, shoulder and wrist. 

Osteoarthritis is a progressive disease that causes inflammation, pain, stiffness and swelling of joints. The joints of the body are the areas where two or more bones meet. The ends of the bones are protected by a tissue called cartilage, which helps bones to move easily without damaging bone tissue. 

Osteoarthritis occurs when the cartilage breaks down or becomes torn or thin. The synovial fluid also loses its ability to lubricate the joint. This results in friction on the ends of the bones as they rub against each other. With time, this causes the classic symptoms of osteoarthritis, such as joint pain, stiffness and swelling.

Your doctor may only suggest viscosupplementation after you have tried other treatments to help your osteoarthritis symptoms, such as over-the-counter pain medication and lifestyle changes.

Who performs viscosupplementation with hyaluronic acid?

Orthopedic surgeons and rheumatologists perform viscosupplementation with hyaluronic acid. An orthopedic surgeon specializes in the medical and surgical treatment of diseases and conditions of the bones, joints, and connective tissues. A rheumatologist specializes in diagnosing and treating arthritis and other rheumatic diseases. Rheumatic diseases affect your joints, tendons, ligaments, bones or muscles.

How is a viscosupplementation with hyaluronic acid performed?

Your viscosupplementation with hyaluronic acid injection will be performed in an outpatient setting, such as the doctor’s office. 

The procedure generally includes these steps:

  1. Your doctor or care team will clean the injection site.
  2. Your doctor will insert a needle into your joint and withdraw synovial (joint) fluid. 
  3. Your doctor will inject synthetic hyaluronic acid into your joint. 
  4. Your doctor will repeat this process once a week for a few weeks. The time between injections and number of injections during the course of treatment depends on the type of synthetic hyaluronic acid that your doctor uses.
  5. You will likely go home soon after your viscosupplementation with hyaluronic acid injection. 

Will I feel pain?

Your comfort and relaxation is important to both you and your care team. You will feel a brief pinch or prick during the needle insertion. Your healthcare team will give you sufficient pain and sedative medications if you need them to stay comfortable. Tell your doctor or care team if you are uncomfortable in any way.

What are the risks and potential complications of viscosupplementation with hyaluronic acid?