Here at Direct Orthopedic Care (DOC), many patients come to us as an attempt to avoid surgical intervention. One of the common treatments our providers will suggest before recommending surgery to a patient is viscosupplementation. Many of our patients have never heard of this treatment before having an injection at one of our four locations in the Boise area.  

What is viscosupplementation?

Viscosupplementation often referred to chicken shots or hyaluronate injections are used to treat osteoarthritis in the knee. This gel-like substance is injected into the knee joint; the purpose is the mimic synovial fluid in the knee. When a knee is affected with osteoarthritis the cartilage is damaged and the synovial fluid can’t lubricate the joint.  The viscosupplementation injections contain hyaluronic acid which occurs naturally in synovial fluid, it helps lubricate and reduce friction in the joint.

These injections were first approved for use by the US FDA in 1997. They are to be used after other conservative treatment options are unsuccessful, such as physical therapy, heat and ice applications, anti-inflammatories, or use of steroid injections such as Kenalog. There are multiple makers of these hyaluronic acid treatments. Hyalgan was one of the first injections to be approved, in 1997, it is a series of 5 injections. Euflexxa is a series of 3 injections, approved by the FDA in 2004. One of the newest treatments is one injection approved in 2011, Gel-One.

Will it help my knee pain?

Patients who report success with these injections generally have the greatest relief between two and three months. Most insurance companies allow patients to repeat these injections after six months. Additionally, some insurance companies prefer patients to try a 3 or 5 series before trying a single dose such as Gel-One. But like any course of treatment they do not work for everyone. Research has shown these injections to be most successful when patients are just developing osteoarthritis. Patients who have advanced osteoarthritis may have to look at other options such as knee replacement for relief.

Patients can expect some mild pain, and an uncomfortable feeling once the fluid is injection into the joint. Although some patients experience pain at the injection site, swelling, redness, heat, rash, itching, bruising, or fluid in the injection join. Other rarer side effects include infection, bleeding, or even and allergic reaction.

If you have osteoarthritis and would like to learn more about viscosupplementation come into DOC any day of the week.  


Viscosupplementation Treatment for Knee Arthritis. OrthoInfo. American Academy of Orthopaedic Surgeons (AAOS). June 2015.