Viscosupplementation
What Is Viscosupplementation?
Viscosupplementation is an injection treatment that supplements the natural joint fluid with hyaluronic acid, a thick, gel-like substance that occurs naturally in healthy joints. In a healthy knee or shoulder, hyaluronic acid gives the joint fluid its normal viscosity, helping cushion and lubricate the joint surfaces as they move against each other. In arthritic joints, this fluid tends to become thinner and less effective at cushioning the joint, contributing to pain and stiffness. Viscosupplementation aims to restore some of this natural lubrication, often described by patients as a “gel shot” or “joint lubrication injection.”
When Is Viscosupplementation Needed?
Viscosupplementation is most commonly used for:
- Mild to moderate osteoarthritis, particularly in the knee, where it has been studied most extensively
- Patients who want to delay joint replacement surgery while managing symptoms
- Patients who haven’t gotten adequate or lasting relief from cortisone injections, or who wish to avoid frequent corticosteroid use
- Ongoing joint pain and stiffness that interferes with daily activities like walking or climbing stairs
How Is Viscosupplementation Performed?
The procedure is performed in the office, with the hyaluronic acid solution injected directly into the joint, sometimes with ultrasound guidance to ensure accurate placement. Depending on the specific formulation used, this may be given as a single injection or as a short series of injections spaced roughly a week apart. Most patients tolerate the procedure well and resume normal activity the same day, with only mild, temporary soreness at the injection site in some cases.
How Long Does It Take to Work, and How Long Does Relief Last?
Unlike a cortisone injection, which often provides relief within days, viscosupplementation typically takes longer to take effect — often a few weeks — as the added lubrication gradually improves how the joint moves and feels. When it’s effective, however, the relief tends to last considerably longer than a cortisone injection, often six months or more in appropriately selected patients.
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Viscosupplementation vs. Cortisone vs. PRP
These three injection types work in different ways and are often used at different stages of a treatment plan. Cortisone injections work quickly to calm inflammation but provide comparatively shorter-lasting relief and are limited in how often they can be repeated. Viscosupplementation takes longer to work but can provide longer-lasting symptomatic relief, particularly for mild-to-moderate arthritis, without the tissue-weakening concerns associated with frequent cortisone use. PRP, discussed on our dedicated PRP Injections page, takes a more biologically active approach, aiming to modulate inflammation and support the joint’s own tissue rather than simply adding lubrication. None of these injections reverse existing arthritis or regrow lost cartilage, but each can play a meaningful role in a broader, individualized treatment plan.
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Dr. Palsis specializes in the treatment of knee, shoulder, and sports injuries.