Hyaluronidase or hyaluronic acid (HA) is a kind of lubricant that occurs naturally in our bodies, both within joints and between myofascial layers, but it decreases as we age.

What to expect:

Using ultrasound for guidance, our physicians inject HA to reduce pain and swelling and to improve function in arthritic joints (such as knees and hips), in and around tendons and in bursae. Anaesthetic is routinely used prior to the injection to maximize comfort.


Typically one small weekly injection for about 3 weeks, or one larger injection once.

Immediate after-effects:

Most people experience little or no downtime, although all patients are advised to avoid unduly stressing the joint for 2 days or so post procedure. Very occasionally a patient will react with a sore and swollen knee which usually settles spontaneously or may need some anti-inflammatory treatment.(Synthetically produced HA is recommended for those who are sensitive in any way to bird products.)

Advanced/severe arthritis:

HA treatment for advanced arthritis of the knee is generally less successful than mild to moderate arthritis due to there being less cartilage left to protect.

Recent studies suggest that PRP (Platelet Rich Plasma) therapy which is performed at CSOM, works better in the long term to protect the joint than HA treatment.  Advantages of HA include less expense and no blood draw, and sometimes it is used in conjunction with orthobiologics (PRP, stem cells etc).

Each patient is assessed for their individual needs to determine what treatment pathway is likely to suit best.

(see also PRP Therapy)