When successful, viscosupplementation can provide knee osteoarthritis pain relief for 3 months or even a year, with the greatest pain relief typically found between 5 and 13 weeks. During this period, one study found3, patients showed a measured average improvement in pain of 11 to 54% and improvement in function of 9 to 15%, similar to the typical effects of NSAID medication.

While viscosupplementation works for some knee osteoarthritis patients, it is not a surefire treatment for everyone. One large study published in 2012 questioned the usefulness of viscosupplementation altogether. However, most physicians still consider it a useful treatment option, to be used when other methods of non-surgical pain relief have failed to provide sufficient pain relief.

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Can Viscosupplementation Treatment be Repeated?

When the pain relief wears off, patients may get another series of injections. Doctors and insurance companies typically require at least 3 months in between the initial injection and the second round of injections.

Viscosupplementation treatments can be repeated one or more times but may not work indefinitely. Osteoarthritis is likely to progress, and over time a patient may find viscosupplementation injections no longer provide adequate pain relief.

If the initial knee injection series does not provide meaningful pain relief, subsequent injections are not likely to provide pain relief and are not recommended.

Hyaluronic Acid Versus Hylans

Hyaluronic acid, which is naturally found in joint fluid, is sometimes referred to as hyaluronan, hyaluronate or HA.

Substances called hylans are derivatives of hyaluronic acid, meaning the two are chemically similar. The term viscosupplementation includes hyaluronic acid as well as hylan injections. Both types of injection therapies aim to decrease pain and improve joint movement.

Current clinical research does not show either type of injection providing better pain relief over the other.


  1. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD005321. Review. Update in: Cochrane Database Syst Rev. 2006;(2):CD005321. PubMed PMID: 15846754.