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Updated July 2022
Hyaluronic acid is used to treat osteoarthritis, a condition that affects the joints. It may be used to treat osteoarthritis of the knee. It is not used as a treatment for rheumatoid arthritis.
In a normal joint a layer of cartilage or gristle covers the ends of the bones. Cartilage helps the joint move smoothly and cushions the ends of the bones. In osteoarthritis cartilage breaks down and becomes thin. This leaves the ends of the bones unprotected and the joint loses its ability to move smoothly.
Hyaluronic acid is found naturally in joints and other parts of the body. In the joint it is found in the cartilage and the synovial fluid that lubricate the joints to keep them working smoothly.
In people with osteoarthritis the hyaluronic acid gets thinner and it is no longer able to protect the joint. Hyaluronic acid injections into affected joints may be offered to people with osteoarthritis of the knee if other treatments have not worked or are unsuitable.
Emerging evidence indicates that the effect of hyaluronic acid could be smaller than previously reported.
A 2022 review of the clinical trials of hyaluronic acid demonstrated that hyaluronic acid injections may lead to a small reduction in knee osteoarthritis pain. However, this reduction in pain was not considered clinically important. There was also evidence that injection of hyaluronic acid is associated with an increased risk of serious adverse effects.
Your doctor will inject the hyaluronic acid directly into the knee joint. Local anaesthetic is sometimes used before the injection. Injections may be given once a week for three weeks or a single injection depending on the product/brand your doctor recommends.
Hyaluronic acid may be used with other arthritis medicines including:
There are separate information sheets for the medicines mentioned above
Most side effects of hyaluronic acid are limited to the site of injection, some may be serious. Tell your doctor if you are concerned about possible side effects.
Local side affects may include:
These local reactions may be treated by resting and applying ice to the injected area or by simple pain relievers.