1. What is Hyaluronic Acid?

HA is a molecule found naturally throughout the human body. It is an important component of the joint fluid (synovial fluid), tendon lubrication, skin tension, and tissue healing.

For joints, the synovial fluid acts like a lubricant to cushion the forces and provide nourishment to the cartilage. Too little synovial fluid “dry knee” starves the knee joint of nutrients and increases the forces on the cartilage, causing early deterioration (arthritis). To much synovial fluid “water-on-the-knee” is usually an indication of arthritis, trauma or synovial disease causing an overproduction of fluid to compensate for lack of nutrients, trauma or lack of biological control. HA is extremely important throughout the life of our joint, to maintain balance and decreases forces that cause deterioration.

2. What condition is Hyaluronic Acid injection used for?

Hyaluronic acid injections are used to relieve painful arthritis, tendonitis, fasciitis, and in non-orthopaedic conditions can be used as cosmetic fillers, scar treatments and wrinkle treatment.

3. What should I expect after a Hyaluronic Acid injection?

As with any invasive joint procedure, it is recommended to avoid strenuous activity (e.g. tennis, jogging or long walks) for the first two days after the injection. During the first week following the injection, some transient reactions related to the injection may occur. Symptoms such as pain and/or swelling/stiffness of mild to moderate intensity can be anticipated. If the symptoms last for more than a week a doctor should be contacted. If there are any adverse reactions after an injection, such as hives or extreme pain and swelling, the doctor should be notified asap.

4. How long do Hyaluronic Acid injections last?

Hyaluronic Acid injections for knee arthritis can have benefit of up to 1 year, depending on the disease process, size of joint and activity of the patient. Most patients get a benefit from 6 to 12 months and we recommend 1 to 2 injections per year to keep the joints lubricated and healthy for years to come.

5. How do Hyaluronic Acid injections work?

These injections contain high levels of concentrated hyaluronic acid (HA), which mimics the effects of natural HA. It restores the levels of HA which are naturally diminished during the progression of osteoarthritis (OA). HA is known to reduce inflammation and pain, as it possesses viscoelastic and biological properties, it can provide cushioning and shock absorption. HA is also known to help maintain the normal fluid balance in a joint and help restore normal joint function.

6. Why is Hyaluronic Acid important in osteoarthritis?

The HA in your joint tissues is continuously broken down and replaced over time. During the slow progression of arthritis, the HA is broken down faster than it is replaced in the joint tissues. This has a negative effect on the properties of the joint fluid causing it to change and stop working properly.

7. How effective are Hyaluronic Acid treatments?

Intra-articular hyaluronic acid offers comparable pain relief to pain-relieving drug therapy or injection of corticosteroids, with a longer duration of action.

8. Can I repeat the treatment?

Yes. The treatment can be repeated on an as needed basis. For conditions like arthritis, we recommend 1 to 2 treatments per year.

9. Is there any reason why I couldn’t have a Hyaluronic Acid injection?

Absolute contraindications to HA injections are active infection, allergy to HA (or its

10. Is the Treatment painful?

Like all injections there is a small amount of pain with the procedure, and to make the process less painful we administer a local skin anesthetic and a nerve block prior to giving the Hyaluronic Acid injection to minimize any discomfort. We also recommend Rest, Ice Compression and Elevation (RICE) of the injected body part to minimize pain. Taking a Tylenol and NSAID (eg. Advil) would be beneficial as well.

11. How is the treatment performed?

The procedure is performed in the office and takes approximately 10 minutes. Hyaluronic Acid is administered by injection with or without image guidance as deemed required by the physician.

12. Is my condition serious enough for this treatment?

If you suffer with arthritis pain and have tried numerous treatments to manage your pain (eg. painkillers, lifestyle modifications, etc.) and you still have ongoing pain, then you could be suitable for Hyaluronic Acid treatment.

13. How safe are Hyaluronic Acid injections?

It is a highly purified product produced from either Bacterial Fermentation or derived from Rooster Cone, ensuring that the risk of impurities is close to zero. Hyaluronic Acid is treated by the body in the same way as the body’s own HA and there have been minimal immunological or anaphylactic reactions reported in the literature at the time of writing this article.

14. Which Hyaluronic Acid products do you currently offer in your clinic?


Medical Device Number
MultiVisk – Small 2 ml Compound
Orthovisc – Small 2 ml 00174625, 96599997
Synvisc – Small 2 ml 00962325, 00965294
MultiVisk – 3 2 ml x 3 Compound
Durolane – SJ 1 ml 96599970, 00999363
Orthovisc 2 ml x 3 00174625, 96599997
Monovisc 4 ml 96599984
Synvisc 2 ml x 3 00962325, 00965294
MultiVisk – Dex 6 ml Compound
MultiVisk – Plus 6 ml Compound
Durolane 3 ml 96299999, 00999363
Cingal 4 ml 92099815