Hyaluronic acid(HA) is a naturally occurring substance found in the synovial (joint) fluid. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. In people with osteoarthritis (OA), this fluid becomes diseased and no longer protects the joint effectively. The covering on the ends of the bones (cartilage) can also break down, becoming worn and frayed. These changes may result in inflammation, swelling, tenderness and pain in the joint, which leads to a reduction in mobility.
Although OA is most commonly found in the knee joint, it can also affect other joints such as the hip, ankle, shoulder or hands.
Viscosupplementation is a procedure that can increase the cushioning and lubrication of osteoarthritic synovial, or joint, fluid. Viscosupplementation has been studied as a treatment for osteoarthritis since the 1970s and has been shown to be an effective treatment option in patients who cannot get pain relief from nonmedicinal measures or analgesic drugs. This procedure is not a cure for osteoarthritis of the knee, hip, shoulder or ankle; it is a treatment that may reduce or eliminate pain that occurs with this condition.
With viscosupplementation, your orthopaedic surgeon or sports medicine phsycian injects a gel that is similar to healthy synovial fluid into your joint. The goals of the treatment are to:
Hyaluronic acid does not have an immediate pain-relieving effect. You may notice a local reaction, such as pain, warmth, and slight swelling immediately after the injection. These symptoms generally do not last long. You may want to apply an ice pack to help ease them. For the first 48 hours after the injection, you should avoid excessive weightbearing on the leg, such as standing for long periods, jogging or heavy lifting.
Depending on the product used, treatment may involve 3 to 5 injections. Over the course of the injections, you may notice that you have less pain in your knee.
• Hyaluronic acid does seem to have anti-inflammatory and pain-relieving properties. The injections may also stimulate the body to produce more of its own hyaluronic acid.
• Effects may last for several months.
The success of viscosupplementation may depend on how well the fluid restores the elasticity and lubrication of the synovial fluid. Individual results may vary.
Hyaluronic acid (HA) is a naturally occurring substance in the synovial (joint) fluid that acts as a lubricant and shock absorber, helping bones move smoothly and reducing joint stress. In people with osteoarthritis (OA), this fluid becomes thin and less protective, so HA viscosupplementation injects a hyaluronic acid-based solution directly into the joint to restore cushioning and lubrication.
HA viscosupplementation is most commonly used for osteoarthritis (OA) of the knee, shoulder, hip, or other joints where cartilage and synovial fluid have worn down, leading to pain, stiffness, swelling, and reduced mobility. It is often considered for mild to moderate OA when other conservative treatments (such as medications, activity modification, and physiotherapy) are not enough to control symptoms.
By adding HA back into the joint, viscosupplementation helps:
Depending on the specific HA product used, treatment may involve 3 to 5 injections, usually given once per week over several weeks. Some newer products allow for a single multidose or longer-acting injection, which your sports medicine physician, physiatrist or orthopaedic surgeon will discuss with you.
HA viscosupplementation is not done on the first visit. You must first have a consultation with a sports medicine physician, physiatrist or orthopaedic surgeon at Athlete’s Care to confirm that HA injections are appropriate for your joint condition. After your assessment, the doctor will explain the expected benefits, risks, and timing, and then schedule your viscosupplementation injection(s) as part of your treatment plan.
HA viscosupplementation does not give immediate pain relief like a cortisone injection. You may notice mild local discomfort, warmth, or slight swelling right after the injection, which usually settles quickly with ice and rest. Pain relief often builds gradually over the course of the injection series and may last several months in some patients, helping to reduce pain and improve joint function.
Immediately after the injection, you may feel some local tenderness, warmth, or mild swelling in the joint. These symptoms usually don’t last long; applying an ice pack and avoiding excessive weight-bearing on the leg (e.g., long periods of standing, jogging, or heavy lifting) for the first 48 hours can help ease discomfort.
The duration of pain relief varies from person to person, but many patients enjoy reduced pain and improved mobility for several months after completing a course of injections. For some, HA viscosupplementation can help delay the need for joint-replacement surgery while they continue with physiotherapy and other conservative treatments.
HA viscosupplementation is generally considered safe, with side effects typically limited to localized reactions such as pain, warmth, or swelling at the injection site. Serious complications such as infection are rare but possible, which is why injections are performed by an experienced sports medicine physician, physiatrist or orthopaedic surgeon at Athlete’s Care.
HA viscosupplementation is not covered by OHIP at Athlete’s Care, so there is an additional out-of-pocket fee for this treatment. Many extended health insurance plans partially or fully cover HA injections; we recommend checking with your provider and speaking with our clinic staff about costs and billing options before starting treatment.
At Athlete’s Care, HA viscosupplementation is used as part of a multidisciplinary OA care plan, often combined with physiotherapy, bracing, activity modification, and education on joint-preserving strategies. Your sports medicine physician, physiatrist or orthopaedic surgeon will discuss whether HA injections are appropriate for your stage of arthritis and goals, and help you decide if this treatment aligns with your plan to stay active and delay surgery.
The items listed are all Health-Canada-licensed viscosupplements, and the specific brand used for a patient depends on the clinician’s assessment, the joint being treated, and the product’s dosing schedule. Your sports medicine physician, physiatrist or orthopaedic surgeon will explain which brand and regimen is most appropriate for your condition. Common brands of HA (hyaluronic acid) viscosupplementation used at Athlete’s Care include but are not exclusive to:
SportVis™ is an injection containing STABHA™ (Soft Tissue Adapted Biocompatible Hyaluronic Acid), a special form of hyaluronic acid custom-made for tendons and ligaments, not just joints. It is the only Health-Canada-approved hyaluronic acid product specifically indicated to relieve pain and restore function in damaged tendons and ligaments, such as in tennis elbow, ankle sprains, and other soft-tissue overuse injuries.
A:
Yes, SportVis is available at select Athlete’s Care locations. Please contact the clinic directly or ask your sports medicine physician, physiatrist or orthopaedic surgeon whether it is an option for your specific tendon or ligament injury.
HA viscosupplementation is not booked as a standalone injection; you must first have a consultation with a sports medicine physician, physiatrist or orthopaedic surgeon at Athlete’s Care to confirm whether HA injections are right for your joint condition.
Once you have a consultation and your doctor recommends HA viscosupplementation:
If you do not yet have a referral, your family doctor or another specialist must send a physician referral to the Athlete’s Care location of your choice before the consultation and injection appointments can be arranged.