Key Takeaways
- Allergy-safe option: Visco-3 uses biofermented hyaluronic acid (no chicken or bird ingredients)
- 3-week protocol: Three weekly injections for full treatment course
- Budget-friendly: Often the most affordable viscosupplementation option at $400-$650 per course
- Step therapy choice: Many insurance plans require trying Visco-3 before approving single-shot brands
- Medium molecular weight: Effective cushioning with proven clinical outcomes
What Is Visco-3?
Visco-3 is a three-injection hyaluronic acid (HA) treatment for knee osteoarthritis. Unlike older HA brands that use chicken combs as the source material, Visco-3 is biofermented - meaning it’s produced through bacterial fermentation, making it safe for patients with bird or poultry allergies.
Manufactured by OrthoPharma, Visco-3 has become a popular “step therapy” option - insurance companies often require patients to try this lower-cost brand before approving more expensive single-shot alternatives like Synvisc-One or Gel-One.
Quick Facts About Visco-3
| Feature | Details |
|---|---|
| Treatment schedule | 3 weekly injections |
| Hyaluronic acid source | Biofermented (non-avian) |
| Molecular weight | Medium (1.0-2.9 million Da) |
| Cost without insurance | $400-$650 per course |
| Cost with insurance | $50-$150 copay (varies by plan) |
| Medicare coverage | Yes, Part B covered |
| Duration of relief | 3-6 months (varies by patient) |
| FDA approved | Yes, for knee OA |
Is Visco-3 Right for You?
Visco-3 may be a good fit if you:
- Have bird or poultry allergies (biofermented = allergy-safe)
- Are cost-conscious (often the most affordable HA option)
- Are starting step therapy (insurance often requires trying this first)
- Prefer proven protocols (3-shot regimen has decades of research)
- Want Medicare-covered treatment (Part B covers with proper documentation)
It may not be ideal if you:
- Want the convenience of a single injection (consider Synvisc-One or Gel-One)
- Need ultra-long relief (single-shot brands sometimes last longer)
- Have difficulty committing to three weekly appointments
How Visco-3 Works
Knee osteoarthritis breaks down the natural synovial fluid that cushions your joint. This fluid is rich in hyaluronic acid - a substance that acts like both a lubricant and shock absorber.
Visco-3 injections work by:
- Restoring joint cushioning - The HA supplement replaces what arthritis has worn away
- Reducing friction - Better lubrication means less grinding during movement
- Lowering inflammation - HA has mild anti-inflammatory properties
- Protecting cartilage - May slow further cartilage breakdown
The biofermentation process creates a medium molecular weight HA that’s structurally similar to natural joint fluid.
The 3-Visit Treatment Protocol
Week 1: First Injection
Your doctor cleans the knee, may use a local anesthetic, and injects Visco-3 into the joint space. Some physicians use fluoroscopic (X-ray) guidance for precision, though it’s not required for Visco-3.
What to expect: Mild soreness, possible temporary swelling. Most patients resume normal activity within 24-48 hours.
Week 2: Second Injection
Same process as week one. By this point, some patients begin noticing early improvements in pain or stiffness.
What to expect: Similar mild soreness. Some patients report cumulative benefit starting.
Week 3: Third Injection
Final injection completes the course. Maximum benefit typically develops 2-4 weeks after the last shot.
What to expect: Gradual improvement over the following month. Peak relief usually hits around week 4-6.
Effectiveness: What the Research Shows
Clinical studies on multi-injection HA treatments (including Visco-3) show:
- Pain reduction: 30-50% improvement in knee pain for many patients
- Duration: Relief typically lasts 3-6 months, with some patients experiencing benefits up to 12 months
- Function improvement: Better walking distance, stair climbing, and daily activities
- Response rate: About 60-70% of patients report meaningful improvement
Who Responds Best?
Visco-3 tends to work better for:
- Mild-to-moderate arthritis (Kellgren-Lawrence grades 1-3)
- Younger patients (under 75)
- Normal body weight (obesity reduces effectiveness)
- Active lifestyles (people who want to stay mobile)
Side Effects and Safety
Common Side Effects (5-10% of patients)
- Temporary pain at injection site
- Mild swelling or warmth in the knee
- Stiffness lasting 24-48 hours
- Bruising around the injection area
These typically resolve within 2-3 days without treatment.
Rare Side Effects (less than 1%)
- Infection (very rare with sterile technique)
- Allergic reaction (extremely rare with biofermented HA)
- Severe swelling requiring drainage
- Persistent inflammation
When to Call Your Doctor
Contact your physician if you experience:
- Fever or chills after injection
- Severe pain that worsens over days
- Red, hot, or extremely swollen knee
- Inability to bear weight on the leg
Allergy Safety: The Biofermented Advantage
This is Visco-3’s biggest differentiator. Older HA brands like Supartz or Orthovisc use chicken-derived hyaluronic acid, making them unsuitable for patients with poultry allergies.
Visco-3 is biofermented - produced through bacterial fermentation without any animal ingredients. This makes it:
- Safe for bird/poultry allergies
- Safe for egg allergies
- Lower risk of allergic reactions overall
If you’ve had reactions to vaccines containing chicken proteins or have a known poultry allergy, Visco-3 is often the preferred HA choice.
Insurance Coverage and Step Therapy
Medicare Coverage
Medicare Part B covers Visco-3 when:
- You have documented knee osteoarthritis (X-ray or MRI)
- Conservative treatments failed (6+ weeks of NSAIDs, PT, weight loss, etc.)
- Injection is medically necessary (not cosmetic or experimental)
Your cost: 20% copay after Part B deductible (typically $50-$100 per course)
Private Insurance Step Therapy
Many commercial plans use Visco-3 as a step therapy drug - meaning you must try it first before insurance will approve more expensive brands like Synvisc-One or Durolane.
Typical step therapy protocol:
- Try Visco-3 first ($50-$150 copay)
- If it fails or provides inadequate relief, insurance may approve single-shot alternatives
- Document response (or lack thereof) for prior authorization
This can feel frustrating if you prefer a one-shot option, but it’s become standard practice to control healthcare costs.
Out-of-Pocket Costs
Without insurance:
- Full course: $400-$650 (all three injections)
- Per injection: $133-$217
Compare to single-shot brands ($800-$1,500), and Visco-3’s value becomes clear for self-pay patients.
Visco-3 vs. Alternative Brands
| Feature | Visco-3 | Synvisc-One | Gel-One | Monovisc |
|---|---|---|---|---|
| Injections | 3 weekly | 1 shot | 1 shot | 1 shot |
| HA source | Biofermented | Chicken | Biofermented | Biofermented |
| Molecular weight | Medium | High | Medium | High |
| Cost (no insurance) | $400-$650 | $1,200-$1,500 | $800-$1,200 | $900-$1,300 |
| Relief duration | 3-6 months | 6-12 months | 3-6 months | 6-9 months |
| Bird allergy safe | Yes | No | Yes | Yes |
| Step therapy tier | Tier 1 | Tier 2 | Tier 2 | Tier 2 |
When to Choose Visco-3
- Budget is a priority (lowest cost option)
- Step therapy requirement (insurance mandates it first)
- Allergy concerns (safe for poultry allergies)
- Proven protocol preference (3-shot regimen has longest research history)
When to Consider Alternatives
- Single-injection convenience (Synvisc-One, Gel-One)
- Longer-lasting relief (high molecular weight brands may last longer)
- Step therapy completed (if Visco-3 didn’t work, insurance may approve alternatives)
Frequently Asked Questions
How long does Visco-3 last?
Most patients experience 3-6 months of relief, though some report benefits lasting up to 12 months. Duration varies based on arthritis severity, activity level, and individual response.
Can I get Visco-3 if I’m allergic to eggs or chicken?
Yes. Visco-3 is biofermented (no animal ingredients), making it safe for poultry and egg allergies.
How soon can I walk after the injection?
Most patients walk immediately, though some doctors recommend avoiding strenuous activity for 48 hours. Light walking is typically encouraged to help distribute the HA throughout the joint.
Can I get Visco-3 in both knees?
Yes, though some physicians prefer to stagger treatments (complete one knee’s 3-week course before starting the other). Discuss scheduling with your doctor.
What if Visco-3 doesn’t work for me?
If you complete the full 3-shot course without adequate relief, your doctor can document this for insurance and request prior authorization for alternative brands like Synvisc-One or Durolane.
Is Visco-3 better than cortisone shots?
Different purposes. Cortisone reduces inflammation quickly (lasts 4-8 weeks). Visco-3 restores cushioning (lasts 3-6+ months). Many doctors use cortisone for acute flares and Visco-3 for long-term management.
Does Medicare cover all three injections?
Yes, Medicare Part B covers the full 3-injection course when medically necessary. You pay 20% copay after the deductible.
Can I exercise after Visco-3 injections?
Avoid high-impact activities for 48 hours after each injection. Low-impact exercise (swimming, cycling, gentle walking) is typically encouraged and may improve outcomes.
This information is for educational purposes and should not replace professional medical advice. Always consult your physician before starting any treatment for knee osteoarthritis.
Last medically reviewed: January 15, 2025