Treatment
Hyaluronic acid for joint symptoms
Perhaps a hyaluronic acid injection has been recommended for your knee osteoarthritis. Or you are looking for a way to walk further again without thinking about your knee at every step. You will want to know what this treatment can achieve, what it involves and whether the effort is worthwhile for you.
Open individual sections or all the details on this page.
Knowing the risks and warning signs
Pain, redness or swelling can occur after an injection. A joint infection is very rare but can have serious consequences. If pain or swelling increases markedly, the joint becomes very hot or you develop a fever, you need prompt medical assessment.
If your condition deteriorates significantly, do not wait for a planned follow-up treatment. The urgent help information in Patient services explains how to find medical support when we cannot be reached. Your individual discussion of risks takes account of the preparation used and your existing conditions.
Understanding
A closer look
At OrthoCoast, we discuss hyaluronic acid in the context of your condition and the treatments you have already tried. This includes an open assessment: we offer the procedure, but its benefit in knee osteoarthritis is debated. A decision should therefore be based on realistic, understandable expectations.
What a hyaluronic acid injection means
Hyaluronic acid is a component of joint fluid. During treatment, a preparation containing it is injected into the joint. The underlying idea is to influence the properties of the joint fluid and ease symptoms.
This biological rationale does not establish that damaged joint cartilage is rebuilt. If you encounter the expression ‘cartilage-building injection’, it is worth asking more. Such rebuilding cannot reliably be promised with hyaluronic acid. What matters most to you is whether pain and limitations noticeably improve.
Setting realistic expectations
Studies and professional recommendations assess hyaluronic acid differently. Some studies show no reliably meaningful advantage over a placebo treatment with saline; others report symptom relief. The studies differ in factors such as the preparation used, the severity of osteoarthritis and the length of follow-up. This does not support a general rule that shorter studies necessarily show better results. Because the findings vary, the German S3 guideline on knee osteoarthritis makes no recommendation either for or against hyaluronic acid injections. We consider the procedure together with you, for example if other options do not help sufficiently or are unsuitable. If corticosteroid treatment is also being considered, we discuss its own treatment goal, possible risks and the reasons for a combination separately with you.
We want to establish with you how you would recognise a helpful change. Is it the stairs to your home, a walk or getting up after sitting for a long time? Such a goal also helps with the later assessment. It does not allow us to promise how much benefit treatment will bring or how long it will last.
Further information
The decision starts with your joint
Not every pain around the knee is caused by osteoarthritis. Swelling, an injury, another joint condition or symptoms arising outside the joint may require a different investigation. We therefore check whether the diagnosis fits the course of your symptoms and the examination findings.
Please also tell us what you have already tried and how you got on with it. Regular exercise, changes to loading or medicines may serve a different purpose from an injection. We discuss these options together rather than only comparing individual injections.
What to expect and next steps
How treatment is prepared
Before a possible injection, we clarify the indication, alternatives, risks and costs. Your current medicines, previous reactions to injections and any new conditions are important. Please tell us if you have an infection or if the skin near the intended treatment site has changed, for example become red.
Please do not stop medicines yourself to make treatment possible. Whether special preparation is needed depends on your situation. Where possible, bring existing imaging findings together with the written report and images. You do not need to arrange a new MRI on your own initiative.
What to consider at your appointment and afterwards
The preparation is injected into the intended joint under hygienic conditions. We discuss which preparation will be used, whether one treatment or several appointments are planned, and whether imaging guidance would be useful for your treatment. A general number of injections on our website does not replace this planning.
If, as part of treatment at our practice, you receive a medicine by injection or infusion that can affect your circulation or nerve function, you remain with us for monitoring for at least 30 minutes afterwards. Please allow for this time. Depending on how you feel, longer observation may be needed; when you can leave the practice and drive again is decided individually.
Before leaving the practice, you should be clear about what level of activity is possible initially and when you can return to sport. Please ask if a particular everyday activity makes special demands on you. A physically demanding working day and a quieter daily routine may require different advice.
Your contacts and the next step
At OrthoCoast, hyaluronic acid injections are performed by Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. If you would like to weigh up a recommendation, please mention your symptoms, existing diagnosis and previous treatments when arranging the appointment.
If, after successful treatment, we have agreed during a consultation to continue and have enabled your personal booking access, you can use it to book the planned follow-up appointments. If you experience an unexpected reaction, we first clarify whether the treatment plan should be adjusted.
What matters for your decision
Discussing costs before deciding
Hyaluronic acid injections for knee osteoarthritis are not part of the standard benefits covered by German statutory health insurance. At OrthoCoast, we offer them as a self-pay service. Before a decision is made, we explain the planned services and expected costs. Patients with statutory insurance receive a cost estimate beforehand. Treatment starts only after you have confirmed the self-pay agreement in writing.
Please also clarify whether the quoted amount covers only one treatment or additional services. With private insurance, reimbursement depends on your individual policy; individual services may be excluded. We therefore recommend checking coverage with your insurer in advance on the basis of the specific treatment planned. Reimbursement for other patients is not a guarantee under your own policy.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileYou can discuss with these doctors whether the treatment may be suitable for your concern. Your goals, questions and expectations are part of that discussion.
Frequently asked questions
Is hyaluronic acid the same as PRP?
No. Hyaluronic acid is a different preparation from platelet-rich plasma obtained from your own blood. Benefits, uncertainties and risks need to be considered separately for each procedure and your condition.
Can the treatment prevent the need for a knee replacement?
That cannot be promised. Whether and when joint replacement becomes appropriate depends on your symptoms, function and the overall course. An injection should not be understood as a guarantee that surgery can be avoided permanently.
Should I simply book more appointments if it does not work?
Please discuss a lack of improvement with us. A course is not continued simply because several appointments were originally planned. Together, we review whether the plan should change.
Your next step
