Gel-One for Knee Osteoarthritis: Complete Patient Guide

Key Takeaways

• Gel-One is a single-injection hyaluronic acid (HA) treatment for knee osteoarthritis from Zimmer Biomet
• Made from rooster combs (avian source) - NOT safe for people with bird allergies
• High molecular weight, cross-linked formulation designed for sustained relief
• Average relief lasts 4-6 months for most patients who respond to treatment
• Covered by Medicare Part B and most private insurance plans when medically necessary
• Self-pay cost ranges from $700-$1,000; with insurance typically $100-$300 out-of-pocket

If you’re exploring hyaluronic acid injections for knee arthritis, Gel-One offers the convenience of single-injection treatment from a major orthopedic device company. But is it the right choice for you? Let’s break down everything you need to know.

What Is Gel-One?

Gel-One is an FDA-approved hyaluronic acid injection for treating knee pain caused by osteoarthritis. It’s manufactured by Zimmer Biomet, a global leader in orthopedic devices and joint replacement technology.

The product delivers 3 mL of cross-linked hyaluronic acid in a single injection, designed to restore the natural cushioning and lubrication in your knee joint that arthritis wears away.

Think of it as replenishing the shock-absorbing gel that healthy knees have naturally. When osteoarthritis breaks down this protective fluid, you’re left with bone-on-bone friction and pain. Gel-One temporarily replaces what’s been lost.

Quick Facts About Gel-One

Is Gel-One Right for You?

Gel-One may be a good option if you:

• Have mild-to-moderate knee osteoarthritis diagnosed by a doctor
• Haven’t found adequate relief from conservative treatments (exercise, weight management, over-the-counter pain relievers)
• Want the convenience of a single-injection treatment
• Are looking to avoid or delay knee replacement surgery
• Have Medicare or private insurance (most plans cover HA injections)
• Prefer a product from an established orthopedic company

Gel-One may NOT be appropriate if you:

• Have a known allergy to bird products, feathers, or egg proteins
• Have an active infection in or around your knee
• Have severe, bone-on-bone arthritis (advanced stage)
• Have skin disease or infection at the injection site
• Are allergic to any ingredients in Gel-One

Important allergy warning: Because Gel-One is derived from rooster combs, it may contain trace amounts of bird proteins. If you have any history of allergic reactions to birds, eggs, or feathers, inform your doctor. Non-avian alternatives like Monovisc or Euflexxa may be safer choices.

How Gel-One Works

Healthy knee joints contain hyaluronic acid, a thick, gel-like substance that acts as both a lubricant and shock absorber. It allows your bones to glide smoothly and cushions impact when you walk, climb stairs, or bend your knees.

Osteoarthritis gradually breaks down this natural hyaluronic acid. As it depletes, you lose that protective cushioning, leading to:

• Increased friction between bones
• Inflammation and pain
• Stiffness and reduced range of motion
• Progressive cartilage damage

Gel-One restores this cushioning through a process called viscosupplementation. Once injected into your knee joint, the cross-linked hyaluronic acid:

1. Lubricates the joint - Reduces friction between cartilage surfaces
2. Absorbs shock - Cushions impact during movement
3. Reduces inflammation - May help decrease inflammatory chemicals in the joint
4. Protects cartilage - Creates a protective environment that may slow cartilage breakdown

The cross-linked formulation means the hyaluronic acid molecules are chemically bonded together, creating a gel that stays in your joint longer before your body naturally breaks it down.

The Gel-One Injection Procedure

Here’s what to expect during your Gel-One treatment:

Before the Injection

• Your doctor will review your medical history and knee condition
• You may have X-rays taken if recent imaging isn’t available
• Inform your doctor about any allergies, especially to bird products
• You’ll be asked to remove clothing covering your knee

During the Procedure (15-30 minutes total)

1. Cleaning - Your knee is cleaned with antiseptic solution to prevent infection
2. Numbing (optional) - Local anesthetic may be applied to minimize discomfort
3. Fluid removal - If you have excess joint fluid (effusion), it may be drained first
4. Injection - The doctor injects 3 mL of Gel-One directly into your knee joint
5. Imaging guidance (recommended) - Some doctors use fluoroscopy (real-time X-ray) or ultrasound to ensure accurate placement

After the Injection

• You’ll rest briefly to ensure you feel okay
• You can typically walk out and drive yourself home
• Most people return to normal activities within 1-2 days
• Avoid strenuous activity for 48 hours after injection

The injection itself usually feels like brief pressure rather than sharp pain. The entire office visit typically takes 30 minutes to an hour.

Effectiveness: What the Research Shows

Clinical studies on Gel-One show positive results for many patients with knee osteoarthritis:

Pain Relief:

• About 60-70% of patients experience meaningful pain reduction
• Relief typically begins within 2-4 weeks
• Maximum benefit usually occurs at 4-8 weeks
• Average duration of relief: 4-6 months

Functional Improvement:

• Patients report easier walking, stair climbing, and daily activities
• Reduced morning stiffness and improved range of motion
• Better ability to exercise and stay active

Patient Satisfaction:

• Studies show high satisfaction rates among responders
• Many patients choose repeat treatments when effects wear off
• Single-injection convenience is frequently cited as a major benefit

Important reality check: Not everyone responds to HA injections. About 30-40% of patients don’t experience significant relief. Response rates are higher for mild-to-moderate arthritis and lower for severe, bone-on-bone cases.

Potential Side Effects

Gel-One is generally well-tolerated, but like all medical procedures, it carries some risk of side effects.

Common Side Effects (affect up to 1 in 10 patients)

• Temporary pain or swelling at the injection site
• Warmth or redness around the knee
• Brief increase in knee pain (usually resolves in 1-2 days)
• Mild bruising

These reactions are typically mild and resolve within 48 hours. Ice and over-the-counter pain relievers can help manage discomfort.

Rare but Serious Side Effects (less than 1%)

• Infection in the knee joint (septic arthritis)
• Allergic reactions (rash, itching, difficulty breathing)
• Severe inflammation or swelling
• Blood clots (very rare)

When to call your doctor immediately:

• Severe pain that worsens over 24-48 hours
• Significant swelling that doesn’t improve
• Fever, chills, or signs of infection
• Redness that spreads beyond the injection site
• Difficulty breathing or signs of allergic reaction

Allergy Warning: Bird Products

This is crucial: Gel-One is derived from rooster combs and may not be safe for people with bird allergies.

The manufacturing process purifies the hyaluronic acid to remove proteins and other substances, but trace amounts of avian proteins may remain.

If you have any of these allergies, discuss alternatives with your doctor:

• Bird or poultry allergies
• Egg allergies (especially severe reactions)
• Feather allergies
• Previous reactions to avian-derived products

Safer alternatives for bird allergies:

• Monovisc - Non-avian, bacterial fermentation source
• Durolane - Non-avian, bacterial fermentation source
• Euflexxa - Non-avian, three-injection series
• Orthovisc - Non-avian, three or four injections

Your doctor can help determine whether Gel-One is safe for you or if a non-avian alternative would be better.

Insurance Coverage & Cost

Medicare Coverage

Gel-One is covered by Medicare Part B when deemed medically necessary. This typically requires:

• Documented diagnosis of knee osteoarthritis
• Failed conservative treatment for at least 6 weeks (physical therapy, exercise, weight management, or pain medication)
• Administration by a Medicare-approved provider

Medicare out-of-pocket costs:

• Medicare Part B covers 80% of the approved amount after your deductible
• You pay 20% coinsurance
• Average patient cost: $140-$300 per treatment

Treatment frequency:

• Medicare allows repeat injections every 6 months if medically necessary

Private Insurance

Most commercial insurance plans cover Gel-One and other FDA-approved HA injections. Coverage specifics vary by plan.

What to check before treatment:

• Is viscosupplementation covered under your plan?
• Is prior authorization required?
• What’s your copay or coinsurance percentage?
• Does your plan prefer certain HA brands?
• Are there limits on treatment frequency?

Your doctor’s office can typically verify coverage and estimate your out-of-pocket costs before scheduling treatment.

Self-Pay Costs

Without insurance, Gel-One typically costs $700-$1,000 per injection. This includes:

• The product itself ($500-$700)
• Office visit fee ($100-$200)
• Injection procedure fee ($100-$200)

Costs vary by geographic location and provider. Some clinics offer cash-pay discounts if you ask.

Gel-One vs. Alternative Treatments

Gel-One vs. Other Single-Injection HA Products

Bottom line: All three single-injection options show similar effectiveness. The choice often comes down to your doctor’s preference, allergy history, and insurance coverage.

Gel-One vs. Multi-Injection HA Products

Single-injection advantages:

• Only one office visit per treatment cycle
• One copay instead of three to five
• Faster completion of treatment
• Fewer needle sticks

Multi-injection potential advantages:

• More gradual relief for some patients
• Lower per-injection cost spread over multiple visits
• Opportunity to adjust or stop if early injections don’t work well

Effectiveness: Research shows similar overall outcomes between single and multi-injection HA protocols.

Gel-One vs. Cortisone Shots

Some patients use both: cortisone for acute flares, HA for longer-term management.

Maximizing Your Gel-One Results

To get the best outcome from your Gel-One injection:

Immediately after injection (first 48 hours):

• Avoid strenuous exercise, running, or prolonged standing
• Use ice if you experience swelling (15 minutes every few hours)
• Take over-the-counter pain relievers if needed
• Walk gently to help distribute the product throughout the joint

Weeks 1-4 (building phase):

• Gradually resume normal activities
• Continue gentle exercises recommended by your doctor or physical therapist
• Be patient - full relief may take 2-4 weeks
• Track your pain levels to monitor improvement

Months 2-6 (maintenance phase):

• Stay active with low-impact exercises (swimming, cycling, walking)
• Maintain a healthy weight to reduce knee stress
• Continue physical therapy exercises for strength and flexibility
• Avoid high-impact activities that stress your knees

When considering repeat treatment:

• Most insurance plans cover repeat injections every 6 months
• Many patients schedule their next treatment when pain begins to return
• Some people get longer relief (9-12 months) and don’t need treatment as frequently

Frequently Asked Questions

How long does Gel-One last?

Average duration is 4-6 months, but individual results vary. Some patients experience relief for 3 months, while others get 9-12 months of benefit.

Will the injection hurt?

Most patients describe brief pressure rather than sharp pain. Your doctor can use local anesthetic to minimize discomfort. The anticipation is often worse than the actual injection.

When will I feel relief?

Some patients notice improvement within days, but most see maximum benefit at 2-4 weeks. Give it at least 4 weeks before deciding whether it’s working.

Can I get Gel-One in both knees?

Yes, but doctors typically treat one knee at a time to minimize side effects and allow you to maintain mobility during recovery.

How many times can I get Gel-One injections?

There’s no hard limit. Many patients receive repeat treatments every 6-12 months for years. Discuss long-term management with your doctor.

Is imaging guidance necessary?

While not required, fluoroscopy or ultrasound guidance improves injection accuracy, especially for patients with obesity or complex anatomy. Ask your doctor if they use imaging.

What if Gel-One doesn’t work for me?

If you don’t get adequate relief, alternatives include trying a different HA brand, cortisone injections, PRP therapy, or surgical options for severe cases.

Can I exercise after the injection?

Avoid strenuous activity for 48 hours. After that, gradually resume exercise. Low-impact activities like swimming, cycling, and walking are ideal for knee arthritis.

Will my insurance cover repeat treatments?

Most plans, including Medicare, cover repeat HA injections every 6 months when medically necessary. Verify with your insurance provider.

Is Gel-One better than knee replacement?

Gel-One is for mild-to-moderate arthritis and provides temporary relief. Knee replacement is for severe arthritis and offers permanent structural repair. They serve different purposes.

The Bottom Line

Gel-One offers a convenient single-injection option for managing knee osteoarthritis pain. Backed by Zimmer Biomet’s reputation in orthopedics, it provides 4-6 months of relief for most patients who respond to treatment.

Key advantages:

• One injection instead of multiple visits
• Proven effectiveness for mild-to-moderate knee OA
• Medicare and insurance coverage
• From a trusted orthopedic device manufacturer

Important considerations:

• Not safe for people with bird allergies
• Doesn’t work for everyone (60-70% response rate)
• Provides temporary relief, not a cure
• Best results with mild-to-moderate arthritis

The most important factor isn’t which brand of HA you choose—it’s finding a qualified provider who uses proper injection technique, ideally with imaging guidance, and who takes time to determine whether you’re a good candidate for viscosupplementation.

If you’re considering Gel-One or other hyaluronic acid injections, schedule a consultation with an orthopedic specialist or sports medicine physician to discuss your specific knee condition and treatment goals.

Learn more about viscosupplementation options and compare all HA brands to make an informed decision about your knee arthritis treatment.

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 knee osteoarthritis. The information presented here is based on published research and FDA-approved labeling as of January 2025.

Last medically reviewed: January 2025