Gel injections, also called viscosupplementation, are hyaluronic acid injections that supplement the natural lubricating fluid in your knee joint. They cushion and lubricate the joint, reduce friction, and may help protect remaining cartilage. Some research suggests they may also reduce inflammation and stimulate your body's own hyaluronic acid production.

No, FDA-approved products differ in molecular weight, injection frequency, and formulation. Single-injection products like Synvisc-One and Gel-One require one visit, while others like Synvisc and Supartz need 3-5 weekly injections. Studies show similar effectiveness across brands, though individual responses vary. Your insurance coverage may influence which product your doctor recommends.

Most patients notice gradual improvement over 2-4 weeks after the injection series is complete. Unlike cortisone, which works within days, gel injections need time to integrate into the joint and take effect. Some people experience relief sooner, while others may take up to 6 weeks to notice maximum benefits.

The procedure takes about 5-10 minutes. Your doctor cleans the knee, may apply numbing medication, and uses ultrasound or anatomical landmarks to guide the needle into the joint space. Most patients feel brief pressure or pinching. You may be asked to move your knee gently after injection to distribute the gel.

Yes, you can walk right away, though some doctors recommend avoiding strenuous activity for 24-48 hours. Many patients can return to work the same day. Avoid running, jumping, heavy lifting, or prolonged standing for a few days to give the gel time to settle and reduce post-injection inflammation risk.

Common side effects include temporary pain, swelling, or stiffness at the injection site lasting 24-48 hours. Rare but serious reactions include infection (less than 1% risk), allergic reactions (especially if allergic to birds or eggs for some products), or severe inflammation. Contact your doctor if you develop severe pain, fever, or increasing swelling.

Ideal candidates have mild to moderate knee osteoarthritis who haven't responded well to conservative treatments like physical therapy or medications, but aren't ready for surgery. Gel injections work best when some cartilage remains. They're less effective for severe bone-on-bone arthritis or immediately after cortisone injections.

Studies show mixed results. Cortisone provides faster relief (days vs. weeks) and stronger initial pain reduction, but gel injections may last longer (3-6 months vs. 6-12 weeks). Some research suggests gel injections are more effective for mild to moderate arthritis, while cortisone works better for severe inflammation. Many doctors use both strategically.

Most doctors recommend waiting at least 3-4 weeks after cortisone injections before getting gel injections. Cortisone can interfere with how well gel injections work and increase inflammation risk. If you recently had cortisone and it helped significantly, your doctor may recommend waiting longer or trying cortisone again instead.

No, about 40-60% of patients experience significant pain relief from gel injections, while others see little to no benefit. Effectiveness varies based on arthritis severity, individual biology, and product used. Response to the first series helps predict whether repeat injections will help. Some patients find other treatments work better.

Gel injection costs ($800-$1,500 per injection) reflect research and development costs, FDA approval process, manufacturing complexity, and limited competition. The product itself is expensive, separate from injection fees. Medicare and insurance negotiate lower rates than cash prices. Generic versions aren't available because each product has unique formulations.

Yes, bilateral injections are possible and covered by most insurance when both knees have arthritis. Some doctors prefer separate visits to monitor for side effects and avoid overwhelming the immune system. Single-injection products make same-day bilateral treatment more convenient than multi-injection series requiring multiple visits per knee.

If gel injections provide minimal relief after a full series, options include trying a different gel product, cortisone injections, PRP therapy, radiofrequency ablation, genicular nerve blocks, or advancing to surgical options. Your doctor will review your overall treatment goals and arthritis severity to recommend next steps.

You can safely repeat gel injections indefinitely as long as they continue providing benefit. Most patients get one series per year, covered by Medicare and insurance. Some studies track patients receiving injections for 5+ years without serious safety concerns. Diminishing returns over time may occur for some patients.

Research shows gel injections provide benefits beyond placebo, though the placebo effect does contribute to results (as with all treatments). Multiple studies comparing gel injections to saline injections show statistically significant pain reduction and functional improvement. However, individual responses vary widely, and not everyone benefits.