Complete Guide to HA Brands 2025: All 8 FDA-Approved Options

Key Takeaways

There are 8 FDA-approved hyaluronic acid (HA) injection brands for knee osteoarthritis in 2025
Single-injection options (Synvisc-One, Monovisc, Durolane, Gel-One) offer convenience
Multi-injection brands (Euflexxa, Supartz FX, Hyalgan, Orthovisc) may provide gradual relief
All brands are covered by Medicare Part B when medically necessary
The “best” brand depends on your pain level, insurance, and treatment goals

If you’re considering gel shots for knee arthritis, you’ve probably discovered there isn’t just one option. The FDA has approved eight different hyaluronic acid injection brands, each with its own formulation, injection schedule, and characteristics.

This guide breaks down all eight options to help you understand what makes each brand unique—and which might be right for your situation.

What Are Hyaluronic Acid Injections?

Hyaluronic acid (HA) injections, often called “gel shots” or viscosupplementation, work by restoring the natural cushioning fluid in your knee joint. Think of it as replenishing what arthritis has worn away.

Healthy knee joints contain hyaluronic acid, which acts as both a lubricant and shock absorber. Osteoarthritis breaks down this protective fluid, leading to bone-on-bone friction and pain.

HA injections temporarily replace this fluid, potentially reducing pain and improving mobility for 3-6 months or longer.

The 8 FDA-Approved HA Brands

Single-Injection Options

These brands require only one injection per treatment cycle, making them the most convenient option.

1. Synvisc-One (Sanofi)

Injection schedule: 1 injection
Source: Avian (rooster combs)
Molecular weight: High (6,000 kDa cross-linked)
Average cost: $800-$1,200 per injection
Duration of relief: 6 months average
Special notes: Most widely used single-injection brand; cross-linked for longer-lasting effect

2. Monovisc (Anika Therapeutics)

Injection schedule: 1 injection
Source: Non-avian (bacterial fermentation)
Molecular weight: High (1,000-2,900 kDa)
Average cost: $700-$1,100 per injection
Duration of relief: 6 months average
Special notes: Good option for patients with bird allergies

3. Durolane (Bioventus)

Injection schedule: 1 injection
Source: Non-avian (bacterial fermentation)
Molecular weight: High (20,000 kDa)
Average cost: $750-$1,150 per injection
Duration of relief: 6 months average
Special notes: Highest molecular weight among all brands

4. Gel-One (Zimmer Biomet)

Injection schedule: 1 injection
Source: Avian (rooster combs)
Molecular weight: High (cross-linked)
Average cost: $700-$1,100 per injection
Duration of relief: 6 months average
Special notes: Cross-linked formulation for sustained release

Multi-Injection Options

These brands require a series of injections over several weeks, which some doctors believe allows for more gradual joint restoration.

5. Euflexxa (Ferring Pharmaceuticals)

Injection schedule: 3 injections (1 per week for 3 weeks)
Source: Non-avian (bacterial fermentation)
Molecular weight: Medium (2,400-3,600 kDa)
Average cost: $450-$700 per injection ($1,350-$2,100 total)
Duration of relief: 6 months average
Special notes: Most popular multi-injection, non-avian option

6. Supartz FX (Bioventus)

Injection schedule: 3 or 5 injections (1 per week)
Source: Avian (rooster combs)
Molecular weight: Medium (620-1,170 kDa)
Average cost: $400-$650 per injection
Duration of relief: 6 months average
Special notes: Flexible dosing schedule (3 or 5 injections)

7. Hyalgan (Fidia Pharma)

Injection schedule: 5 injections (1 per week for 5 weeks)
Source: Avian (rooster combs)
Molecular weight: Medium (500-730 kDa)
Average cost: $350-$600 per injection ($1,750-$3,000 total)
Duration of relief: 6 months average
Special notes: Longest-used HA brand (FDA approved since 1997)

8. Orthovisc (Anika Therapeutics)

Injection schedule: 3 or 4 injections (1 per week)
Source: Non-avian (bacterial fermentation)
Molecular weight: High (1,000-2,900 kDa)
Average cost: $400-$650 per injection
Duration of relief: 6 months average
Special notes: Higher molecular weight than most multi-injection options

HA Brand Comparison Table

Brand	Injections	Source	Molecular Weight	Average Total Cost	Relief Duration
Synvisc-One	1	Avian	High	$800-$1,200	6 months
Monovisc	1	Non-avian	High	$700-$1,100	6 months
Durolane	1	Non-avian	Highest	$750-$1,150	6 months
Gel-One	1	Avian	High	$700-$1,100	6 months
Euflexxa	3	Non-avian	Medium	$1,350-$2,100	6 months
Supartz FX	3-5	Avian	Medium	$1,200-$3,250	6 months
Hyalgan	5	Avian	Medium	$1,750-$3,000	6 months
Orthovisc	3-4	Non-avian	High	$1,200-$2,600	6 months

Single-Injection vs. Multi-Injection: Which Is Better?

The debate between single and multi-injection protocols continues in the medical community. Here’s what matters to patients:

Single-Injection Advantages

Convenience: Only one office visit per treatment cycle
Less discomfort: Fewer needle sticks
Lower copays: One visit instead of 3-5
Faster treatment: Complete in one day

Multi-Injection Advantages

Gradual relief: Some patients report smoother onset of benefits
Lower per-visit cost: Spread over multiple billing dates
Potentially longer effect: Some studies suggest cumulative benefit
Second chances: If one injection doesn’t work well, you can discuss alternatives before completing the series

What the research shows: Clinical studies comparing single vs. multi-injection protocols show similar overall effectiveness. The choice often comes down to patient preference and logistics.

Avian vs. Non-Avian Sources

HA injections are produced either from rooster combs (avian) or through bacterial fermentation (non-avian).

Avian-Sourced Brands

Synvisc-One
Gel-One
Supartz FX
Hyalgan

Important: If you have a bird or egg allergy, inform your doctor. Avian-sourced products may not be appropriate for you.

Non-Avian Brands

Monovisc
Durolane
Euflexxa
Orthovisc

Advantage: Safe for patients with bird/egg allergies; produced through controlled fermentation.

Effectiveness difference: No significant clinical difference in outcomes between avian and non-avian sources. The choice matters primarily for allergy concerns.

Understanding Molecular Weight

You’ll notice “molecular weight” listed for each brand. Here’s what it means in plain language:

Higher molecular weight (cross-linked): Thicker, gel-like consistency that stays in the joint longer
Medium molecular weight: Flows more easily, may distribute throughout the joint more quickly
Very high molecular weight: Durolane (20,000 kDa) is designed for maximum residence time in the joint

Does higher molecular weight mean better? Not necessarily. Different formulations work better for different patients. Some respond better to thicker gels, while others benefit from more fluid formulations.

Medicare Coverage for HA Injections

Good news: All eight FDA-approved HA brands are covered by Medicare Part B when medically necessary.

Coverage requirements:

Diagnosis of knee osteoarthritis
Failed conservative treatment (typically 6+ weeks of exercise, weight management, or pain medication)
Treatment administered by a Medicare-approved provider

Out-of-pocket costs with Medicare:

Part B covers 80% after deductible
You pay 20% coinsurance
Average patient cost: $160-$400 per treatment cycle

Private insurance: Most commercial plans also cover HA injections, though specific brand coverage varies. Check your formulary or call your insurance company before treatment.

How to Choose the Right HA Brand

Your doctor will recommend a specific brand based on several factors:

1. Convenience Preference

If minimizing office visits is important, single-injection options (Synvisc-One, Monovisc, Durolane, Gel-One) make the most sense.

2. Allergy History

Bird or egg allergies? Choose a non-avian brand (Monovisc, Durolane, Euflexxa, Orthovisc).

3. Previous Experience

If you’ve tried HA injections before, that history matters. Responded well to a specific brand? Stick with it. Didn’t get relief? Your doctor might try a different formulation.

4. Insurance Coverage

Some insurance plans prefer certain brands. Your doctor’s office can verify coverage before treatment.

5. Doctor’s Experience

Many physicians develop preferences based on their patients’ outcomes. Trust their clinical judgment—they’ve seen which brands work best in their practice.

6. Cost Considerations

If you’re paying out-of-pocket, single-injection brands often cost less overall than multi-injection series.

What to Expect During Treatment

Regardless of which brand you choose, the injection process is similar:

Preparation: Your knee may be numbed with a local anesthetic
Fluid removal: If you have excess fluid (effusion), it may be drained first
Injection: The HA is injected into the joint space (2-4 minutes)
Recovery: You’ll rest briefly, then can usually walk out

Imaging guidance: Some clinics use fluoroscopy (X-ray guidance) or ultrasound to ensure accurate placement. This increases precision, especially for patients with obesity or complex anatomy.

Expected Results Timeline

First 24-48 hours: Some patients experience temporary soreness or swelling. This is normal and typically resolves quickly.

Week 1-2: Pain relief begins for many patients, though some may not notice improvement until week 3-4.

Weeks 4-8: Maximum benefit is usually reached during this period.

Months 3-6: Relief continues for most patients who respond to treatment.

Month 6+: Effects begin to wear off. Many patients schedule repeat treatments every 6 months.

Important: About 60-70% of patients experience significant pain relief from HA injections. Results vary by individual, and not everyone responds to treatment.

When HA Injections May Not Work

Hyaluronic acid isn’t right for everyone:

Severe (bone-on-bone) arthritis: HA works best for mild-to-moderate osteoarthritis
Active knee infection: Treatment must be postponed
Significant knee deformity: Structural issues may prevent proper joint mechanics
Unrealistic expectations: HA provides symptom relief but doesn’t cure arthritis or regenerate cartilage

If HA injections don’t provide adequate relief, other options include:

Corticosteroid injections for inflammation
Platelet-rich plasma (PRP) therapy
Knee replacement surgery for severe cases

Frequently Asked Questions

Can I switch between HA brands?

Yes. If one brand doesn’t work well, your doctor can try a different formulation for your next treatment cycle.

How often can I get HA injections?

Medicare and most insurance plans cover repeat treatments every 6 months. Some patients go longer between treatments if relief lasts.

Are newer brands better than older ones?

Not necessarily. Hyalgan has been used successfully since 1997. Newer brands offer different formulations and convenience factors, but “older” doesn’t mean less effective.

Do single-injection brands hurt more?

No evidence suggests single injections are more painful. The larger volume is distributed throughout the joint space, and local anesthetic is used.

Which brand lasts the longest?

Clinical studies show similar duration across brands (average 6 months). Individual response varies more than brand-to-brand differences.

Can I get HA injections in both knees?

Yes, but many doctors prefer to treat one knee at a time for single-injection brands, or alternate knees for multi-injection series.

Will my insurance cover any brand?

Most plans cover all FDA-approved brands, but some have preferred formularies. Your doctor’s office can verify coverage before treatment.

Are generic HA injections available?

No. All eight brands are name-brand products. There are no FDA-approved generic versions of HA injections as of 2025.

Making Your Decision

The “best” HA injection brand is the one that works for you. Here’s what matters most:

Your doctor’s recommendation based on your specific knee condition
Your schedule and convenience (single vs. multiple visits)
Your allergy history (avian vs. non-avian)
Your insurance coverage and out-of-pocket costs
Your previous experience with HA injections (if any)

Don’t get overwhelmed by comparing brands. Focus on finding a qualified provider who uses imaging guidance, follows proper injection protocols, and has experience with multiple HA formulations.

Next Steps

If you’re considering hyaluronic acid injections for knee osteoarthritis:

Schedule a consultation with an orthopedic specialist or sports medicine physician
Bring your questions about specific brands and treatment protocols
Discuss your goals for pain relief and mobility improvement
Verify insurance coverage for your preferred brand
Ask about imaging guidance (fluoroscopy or ultrasound) during injection

Ready to explore your options? Learn more about how viscosupplementation works and compare specific HA brands in detail.

Last medically reviewed: February 2025

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider about treatment options for your specific condition.