What Do We Charge
Ostenil Plus: 40mg/2mls £290 per injection // Durolane: 60mg/3mls £350 per injection
All injections are performed under ultrasound guidance and the fee is all inclusive for assessment, injection and written report. See here for more information on our fees.
If you require any further information, please do not hesitate to contact us by calling 0207-482-3875 or sending an email with your enquiry .
Differences In Reported Adverse Events
We compiled all NSAEs and SAEs reported in our review and in the review by Rutjes and colleagues . As in our own review, we classified AEs reported by Rutjes and colleagues as serious or non-serious, and then further by whether the AE was local to the knee joint, local to somewhere other than the knee joint, or a non-local AE. Rutjes and colleagues reported results for one NSAE and then used the original study authors assessment of AEs as serious or non-serious for their determination of SAEs. We then compared the types of NSAEs and SAEs reported in our review to the NSAEs and SAEs in the review by Rutjes and colleagues .
What Does Hyaluronic Acid Do In The Knee Joint
In the osteoarthritic knee, the quality and quantity of hyaluronic acid in the joint fluid reduces causing pain, stiffness, and swelling in the joint. ReadWhat Is Hyaluronic Acid?
A healthy knee joint contains up to 4 mL of joint fluid.3Kraus VB, Stabler TV, Kong SY, Varju G, McDaniel G. Measurement of synovial fluid volume using urea. Osteoarthritis Cartilage. 2007 15:1217-20. Hyaluronic acid is a key component of the joint fluid. It gives the joint fluid its viscous, slippery quality, which does the following:
- Enables the bones’ cartilage-covered surfaces to glide against each other, thereby reducing joint friction
- Adds cushion to protect joints during impact
See Knee Anatomy
Joints affected by osteoarthritis typically have a lower concentration of hyaluronic acid in their joint fluid than healthy joints, and therefore less protection against joint friction and impact.4Altman RD, Manjoo A, Fierlinger A, Niazi F, Nicholls M. The mechanism of action for hyaluronic acid treatment in the osteoarthritic knee: a systematic review. BMC Musculoskelet Disord. 2015 16:321. Published 2015 Oct 26. doi:10.1186/s12891-015-0775-z Experts believe this further accelerates the joint degeneration process, setting in place a vicious cycle.
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Why Have A Hyaluronic Acid Injection Over A Steroid Injection
Hyaluronic acid may be favoured by some patients for a range of reasons. Some patients are not able to have steroid injections for medical reasons. Some patients may only experience short lived relief from steroid injections. Also, we have to observe limits on the number of steroid injections that a patient can have , otherwise the steroid injection may eventually cause a detrimental effect to the soft tissue and joint.
However, hyaluronic acid offers a significantly different option and may be a viable solution for maintaining comfort in the knee, especially for patients who are active. They work in a very different way to steroid injections in that they help to replenish and nourish the joint . There is some evidence they may even be able to slow down the progression of osteoarthritis as part of an overall maintenance program including strengthening, weight management and activity modification.
How Are They Taken
You will be given a hyaluronan injection into your joint. This is known as an intra-articular injection.
A nurse or trained healthcare professional will check you carefully and talk about whether the injection is suitable for you. They will give you the injection.
You may receive between one and five injections, usually a week apart, depending on which brand of hyaluronic acid your healthcare professional uses.
For at least two days after the injection, you should avoid jogging, high-impact sports or being overly active. You should also avoid carrying heavy items or standing for long periods.
You might not notice the effect of the injections straight away. Once they start working, any benefits will probably last a few months.
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Is Hyaluronic Acid Considered To Be Regenerative
Studies have shown the use of hyaluronic acid has helped the body to increase its own production of hyaluronic acid, which is present within the naturally created synovial fluid. Another benefit is that hyaluronic acid injections can help preserve the cartilage from breaking down any further! Plus, hyaluronic acid is considered to have regenerative features because it prompts the body to produce its own healthy cells. You can read more about how our hyaluronic acid injections work on our Resources page.
How Long Does A Viscosupplementation Injection Last
Generally, the higher concentration gel injections last from 6 to 12 months.
A recent study sheds light on how long Durolane injections last. Generally, the effect of one single injection lasted, on average, about 466 days. However, in some cases, Durolane lasted for greater than 100 days. Also, subsequent injections lasted as long as the first injection for up to 6 injections. Finally, 75% of people who had a Durolane injection were satisfied.
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Who Can Take Hyaluronan Injections
Hyaluronan injections can be used to treat arthritis. But theyre usually only prescribed if other treatments havent worked first.
NICE is an organisation that provides information about treating and caring for different conditions in the UK. It currently doesnt recommend using hyaluronan injections for osteoarthritis.
NICE suggests that hyaluronan injections may reduce pain over six months. But the injections may cause short-term inflammation in the knee.
However, some doctors dont agree with this advice and continue to legally prescribe hyaluronan injections.
You may want to discuss if hyaluronan injections are an option for you with your healthcare team. This is because different NHS locations may have different policies.
Hyaluronan injections are also available at private clinics around the UK, where you pay for the treatment yourself.
You wont get hyaluronan injections if you have:
- a bleeding or blood clotting disorder, such as haemophilia
- certain allergies
- an infection in your knee or in the skin around your knee.
Hyaluronic Acid Injections Best For Moderate To Severe Pain
This is the next line of treatment for people with mild to moderate knee pain thats not responding to painkillers.
Receiving intra-articular hyaluronic acid into the knee joint :
- Can provide relief from knee pain more effectively than NSAIDs or placebos.
- Has a lower risk of side effects than painkillers.
- Requires only one dosage every 6 to 12 months.
- Provides lasting relief from osteoarthritis symptoms.
Cons of injections
- They cant be used by those with allergies to hyaluronic acid.
- May cause pain at the site of injection.
- Requires a visit to the clinic, as it cant be self-administered.
- Needs a prescription, as professional medical advice is required first.
Dosage of injections
Hyaluronic acid injections can range from 0.5 to 6 ml, and even the concentration per ml of injection can vary from 0.8 to 30 mg/ml.
The amount should be determined by your doctor, according to your symptoms, health status, and other factors.
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Combining Prp And Hyaluronic Acid
A team of Italian researchers examined the role of a combined hyaluronic acid and PRP treatment in a March 2021 published study.
In this study, clinical outcomes of patients suffering from mild or moderate knee osteoarthritis were treated with Leukocyte and platelet-rich plasma or PRP + hyaluronic acid intra-articular injections. Outcomes were observed 3 months and 1 year after the injective treatment.
A significant improvement of pain score was present in both groups, the Leukocyte PRP group, and the PRP + hyaluronic acid. Pain reduction was effective after 3 months and improved after 1 year. The group treated with PRP + hyaluronic acid showed a significant improvement in knee mobility and function scores. In both groups, however, the improvement in Knee injury and Osteoarthritis Outcome Score , a self-reported measure of functional ability and knee-related quality of life, did not reach significance.
What does this mean? The researchers concluded: In our point of view, we encourage the use of PRP injections as a simple, safe, and minimally invasive treatment approach. Our comparison of PRP + hyaluronic acid and Leukocyte-PRP suggests that PRP + hyaluronic acid could possibly determine better functional and mobility outcomes. However, our work could not be sufficient to definitively suggest a therapeutic choice: Further evidence is needed.
What is Leukocyte- and platelet-rich plasma treatment? What is its connection to hyaluronic acid?
Does Molecular Weight Of Hyaluronic Acid Matter
Generally, molecular weight refers to how heavy the hyaluronic acid molecules are. Viscosupplementation can be high molecular or low molecular weight. High molecular weight only needs one injection as it more potent and lasts longer in the joint.
There is some debate about whether high or low molecular weight is better. However, recent evidence suggests that high molecular weight hyaluronic acid is better. In one study, the effect of high molecular weight was at least double the low molecular weight. In addition, the Arthroscopy Association of Canada suggests that high molecular weight hyaluronic acid demonstrates a good effect on knee and hip arthritis pain.
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Who Should Consider Hyaluronan Injections
Hyaluronan injections are a viable option when other treatments have not worked. Usually, people consider these injections when they have failed exercise, tablets, and cortisone injections. For example, some people can not take common anti-inflammatories like Ibuprofen due to stomach ulcers or previous heart attacks.
They are often used to treat knee pain caused by osteoarthritis in patients whose symptoms do not get better with painkillers or non-drug treatments such as heat or ice. In fact, hyaluronic injections are also often tried by people who can not take painkillers like Acetaminophen , Ibuprofen , or Naproxen Sodium due to their heart or other issues.
They are also an alternative for patients who can not have total knee replacement or other surgeries.
What Are Hyaluronic Acid Joint Injections
Hyaluronic acid is similar to a substance that occurs naturally in the joints, and acts as both a lubricant and a shock absorber, helping the joint to work properly. Hyaluronic acid injections, also known as HA injections or gel injections, are used to treat knee pain in people with osteoarthritis of the knee for whom other treatments have been unsuccessful.
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Benefits Of Hyaluronate Injections
Hyaluronate injections offer a viable alternative to oral medications, which can have unwanted side effects or are completely ineffective for some people. If your arthritis does respond, the injections offer a very real solution to help you delay surgery or allow you to feel less pain as you wait for surgery to resolve your arthritis pain.
Some research also suggests that the injections can encourage your body to produce more of the substance naturally, which only helps keep remaining cartilage healthy and preserves knee function.
To learn about hyaluronate knee injections and other therapies for your knee pain, call Urgently Ortho in Scottsdale, Arizona, or book a consultation using this website. We strive to help people in the Phoenix area overcome pain and dysfunction in joints so they can resume a high quality of life.
Side Effects Of Knee Osteoarthritis Injections
Potential side effects of these knee osteoarthritis injections include joint swelling and pain. They can’t be used by people with skin or joint infections. In addition, most varieties are made from processed chicken or rooster combs and should not be used in people with egg or poultry allergies. Euflexxa, however, is safe to use in people with egg allergies.
Occasionally, a severe reaction with swelling, redness, and pain, called a pseudoseptic reaction, can occur with some forms of these viscosupplementation materials.
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Questions To Ask When Choosing Hyaluronic Acid Injection Treatment For Knee Osteoarthritis
While deciding to choose hyaluronic acid injections for the knee, it may help to ask the doctor a few questions regarding the treatment. Asking relevant questions will help weigh the potential risks and benefits of these injections and set reasonable expectations.
A few examples of questions that can be asked are:
- What is the typical outcome for a patient like me?
- Will there be an immediate reaction in my knee after the injection?
- What are the risks associated with this injection?
- How long will my recovery be?
- Is it recommended to take time off work?
- How might this injection affect the chances of postponing my knee replacement surgery?
- Do I need to do anything to prepare for the injection?
- What other treatments can be considered?
How Long Does Relief Last
It is quite variable but many patients report six months of relief, and the injections may be repeated every six months or based on physician judgement, Dr. Miller says. Our Facebook community confirms this, with most patients telling us relief lasted from four to six months they got the shots every six months. But, as Sarah Quina shared, they dont work repeatedly forever. Also, the shots may take several weeks to go into effect, unlike steroid injections, which work much faster.
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Why Might I Need Viscosupplementation Treatment For Arthritis
You may have already tried other treatments for your arthritis, like over-the-counter pain medicines and corticosteroid injections. If you still have significant symptoms, viscosupplementation might be a good choice to help reduce your pain, stiffness, and swelling. The treatment seems to work best in people with mild or moderate arthritis. The treatment may particularly make sense if you are trying to delay getting surgery on your joint.
Generally, healthcare providers use viscosupplementation to treat osteoarthritis, but the technique may also benefit people with certain other kinds of arthritis, like rheumatoid arthritis. You can talk to your healthcare provider about whether it is a choice for your type of arthritis.
Hyaluronic acid injection is not a treatment choice for arthritis in all types of joints. The knee is the standard injection site, but you might also be able to get it for arthritis in your hip or possibly in another location.
How Often Can You Get Hyaluronic Acid Injections For The Knee
Generally, the injections should last up to 12 months with the higher molecular weight hyaluronic acid. Therefore, we think it is safe to have a repeat injection every 6-12 months. However, one recent study found that the HA injection lasted 450 days, and some lasted more than 1000 days. In that same study, they found that repeated shots continued to work as the first shot for up to 6.
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Is There More Than One Type Of Hyaluronic Acid
There are two types of hyaluronic acid injections available, each with its own benefits and drawbacks. The type we prefer to use is a product called GenVisc because it matches closely with the natural-occurring hyaluronic acid already in the body. The other type of hyaluronic acid is artificial and is derived from avian products. It is also known as the chicken or rooster shot because it is sourced from the rooster comb. We can use artificial products, but we prefer to use natural hyaluronic acid as it seems to last longer and has a lower risk of side effects. GenVisc is delivered directly into the joint in a series of injections and can provide long-lasting relief from knee pain for months or even years.
Hyaluronic Acid Injections For Osteoarthritis Of The Knee
Hyaluronic acid injections are not just good for pain. They are also good for osteoarthritis. If you have knee osteoarthritis, you may find that injecting hyaluronic acid is one of the most helpful and natural treatments that you can get.
Osteoarthritis, also known as just arthritis, is a condition that causes the cartilage and bones that make up your joints to wear down. This can lead to pain and stiffness in the joint and limits your range of motion. Hyaluronic acid injections can help to reduce these symptoms and improve your quality of life, and has been shown to be effective in mild, moderate, and even severe arthritis. There are a lot of studies on Hyaluronic acid that show that participants who received HA injections reported significant improvement in knee function, compared to those who received a placebo injection.
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Knee Pain Relief Injections
Friction in the knee joint from wear and tear causes pain, inflammation and stiffness. While replacing or restoring cartilage is difficult and invasive, restoring higher levels of hyaluronic acid can be accomplished with injections. Synthetic hyaluronic acid with viscosupplementation knee injections can provide a slippery substance to coat the ends of the bones within the knee joint. This can relieve friction during movement that creates swelling and pain in the knees, allowing for better mobility.
Hyaluronic acid injections for knee pain may not provide immediate relief, but it can relieve pain over time. Patients often experience less knee pain from arthritis for several months after viscosupplementation injections. Most patients will require a series of injections over a few weeks to obtain the best outcome for relief of knee pain.
If you have tried conservative options for relieving your arthritic knee pain and other symptoms, knee injections of hyaluronic acid may be right for you. To learn more about viscosupplementation knee injections and our other interventional treatments for knee pain, contact us at DOCS Health in Los Angeles to schedule your knee pain consultation.
How Do I Know If Hyaluronic Acid Injection Is Appropriate For Me
This may be discussed with your GP or orthopaedic consultant. You are very welcome also to contact one of our team of expert clinicians via who will always be very happy to answer any queries that you may have. Our team has vast experience in the use of hyaluronic acid and therefore will be able to guide you as to whether or not this treatment is appropriate for you.
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