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  • Cynthia M. Johnson, MA
Publication Type:



(Hyaluronic Acid Injection; Injection, Hyaluronic Acid)


Viscosupplementation is an injection of a fluid called hyaluronic acid into a joint, most commonly the knee or shoulder.

Reasons for Procedure

Healthy joints contain synovial fluid. It lubricates joints and helps them move more easily. With osteoarthritis, this fluid becomes thin which makes it harder for the joint to move. Hyaluronic acid is found in synovial fluid. It is injected into the joint to ease pain and improve movement in people with OA. It is done when other methods have not helped.

Joints Affected by Osteoarthritis.

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Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from hyaluronic acid or anesthesia, such as wheezing or sore throat
  • Infection at the injection site
  • Inflammation of the blood vessels—vasculitis
  • Gout

Things that may raise the risk of problems are:

  • Chronic diseases, such as diabetes or obesity
  • Problems with joint alignment

What to Expect

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, bleeding, or discharge from the injection site
  • Increased pain or swelling in the affected joint
  • Pain that you cannot control with medicine

If you think you have an emergency, call for medical help right away.

Prior to Procedure

The care team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the injection
  • Arranging for a ride to and from the injection


Local anesthesia will be given. The area will be numbed.

Description of the Procedure

A needle may be used to remove any excess fluid in the joint. Then, a needle will be used to insert the hyaluronic acid into the joint. The injections may need to be repeated over a period of days. A bandage may be placed over the area.

How Long Will It Take?

A few minutes.

Will It Hurt?

Anesthesia will prevent pain during the injection. There may be mild pain, warmth, and swelling after the injection. Medicine and self care can help.

Post-procedure Care

At the Care Center

After the injection, the staff may give you pain medicine.

At Home

It will take a few days for the discomfort to go away. Physical activity will be limited during this time. You may need to ask for help with daily activities and delay your return to work.





  • Arthrocentesis (Joint aspiration). Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/14512-arthrocentesis-joint-aspiration.
  • Injection therapy for osteoarthritis (OA) of the knee. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/injection-therapy-for-osteoarthritis-oa-of-the-knee.
  • Osteoarthritis (OA) of the glenohumeral joint. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteoarthritis-oa-of-the-glenohumeral-joint.
  • Peck J, Slovek A, et al. A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee. Orthop Rev (Pavia). 2021;13(2):25549.
  • Viscosupplementation treatment for arthritis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/treatment/viscosupplementation-treatment-for-knee-arthritis.


  • Laura Lei-Rivera, PT, DPT
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.