Monovisc for joint pain: the single injection explained

What is Monovisc®?

One injection to help you move more comfortably.

Monovisc® is an ultra-pure, optimised hyaluronic acid (HA) injection for osteoarthritis pain. HA occurs naturally in healthy joint fluid, helping lubricate and cushion movement. Monovisc adds a concentrated dose to support this function.

It may be used in the knee, hip, ankle or shoulder, following clinical assessment, and has been used more than 3 million times worldwide.

A trusted, proven injection – What do studies show?

92.4% of knee patients responded to treatment at 39 weeks, using measures of pain, stiffness and function.
Other reported response rates were 96% for the shoulder, 85% for the knee, 84% for the ankle and 80% for the hip.

How Monovisc works

Monovisc improves fluid inside the joint (synovial fluid), aiming to ease pain, help stiff joints move more freely and protect against further wear. Monovisc can help delay progression toward joint replacement surgery, supporting you in maintaining normal everyday activity levels

Lubrication and shock absorption

Supplementing optimised high-dose (88mg) HA reduces friction in the joint, eases stiffness and supports smoother movement.

Cushioning and protection

The HA binds well to water, forming a gel that cushions a roughened, painful joint surface and protects cartilage (1–8).

Working with nature

Monovisc binds to the cells that make the joint’s own HA (synoviocytes) and has been shown to stimulate them to produce it again (7).

Gradual, lasting benefit

Improvement is often gradual over the first few weeks, with pain reduction sustained beyond six months, proven in clinical studies.

What happens on the day

Assessment and consent

A brief assessment, and a chance to ask questions.

Preparation

The skin is cleaned. If the joint is swollen, some clinicians remove excess fluid first.

The injection

A single pre-filled 4mL injection (88mg HA) goes into the joint. Hip injections are commonly image-guided; knee injections may or may not be.

Home the same day

After a short rest, you go home. Improvement often builds over the first few weeks. Your time in the clinic should be no more than 45mins.

If symptom return

Your clinician will guide the timing of another injection. It is worth contacting your clinician as soon as you notice any slight return of symptoms. Some patients prefer to pre-empt this and have a routine injection every 6, 9, or 12 months.

Combining treatment

A brace or support has shown some benefit when used after an injection. Supporting the joint further during more strenuous activity can be a good idea.

Who Monovisc may suit

Monovisc is used for mild to moderate osteoarthritis, especially when physiotherapy, activity changes and simple pain relief haven’t been enough.

Knee, hip, shoulder or ankle pain

Monovisc is indicated for these joints; your clinician will advise on yours.

People avoiding steroid

Monovisc is hyaluronic acid only, so it suits people who can’t have, or don’t want, a steroid.

People hoping to delay surgery

Clinical studies suggest Monovisc can delay joint replacement surgery (8).

People who need repeat treatment

It is gentle on the joint and can be repeated every 6 to 12 months.

Monovisc FAQs and fast facts

What is Monovisc?

A hyaluronic acid joint injection, often called a gel injection, used to reduce joint pain and stiffness and improve movement when arthritis symptoms get in the way.

How quickly does Monovisc work?

Some people notice improvement within a couple of weeks; for others it builds more gradually. In a knee study, meaningful improvement was seen from two weeks, with outcomes followed through 26 weeks.

How long does Monovisc last?

HA injections aim for months of relief rather than days or weeks, but it varies with the joint, severity, activity, weight and strength. Knee study follow-up commonly runs to around six months.

Is Monovisc a steroid injection?

No. Monovisc is hyaluronic acid only.

How is Monovisc different from other HA injections?

It is a high-dose single injection, crosslinked to stay in the joint longer than thinner HA products, with a range of naturally occurring molecular weights that lubricate, cushion and stimulate the joint’s own HA.

Do I need ultrasound guidance?

It depends on the joint and the clinic. Hip injections are commonly image-guided; knee injections may be guided or not. It is a fair question to ask, but don’t be put off if it isn’t.

Can Monovisc be repeated?

Yes. It is very safe and gentle on the joint, and can be repeated every 6 to 12 months for a number of years.

Does Monovisc cure arthritis?

No. It reduces pain and helps you move better, and the best results come when injections sit alongside rehabilitation and strength work.

References

1. Petterson SC, Plancher KD. Knee Surg Sports Traumatol Arthrosc (2018). doi:10.1007/s00167-018-5114-0.
2. Hangody L, Szody R, Lukasik P, et al. Cartilage 2017 May; doi:10.1177/1947603517703732.
3. Instructions for use for Monovisc, Durolane.
4. Balazs EA. Viscosupplementation for treatment of osteoarthritis: from initial discovery to current status and results. Surgical Technology International (2004).
5. American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee: evidence-based guidelines (2013). doi:10.5435/JAAOS-21-09-571.
6. CINGAL 13-01, a randomized, double-blind, placebo-controlled, active comparator Phase III study.
7. FDA Monovisc Summary of Safety and Efficacy Data (SSED). Application number P090031.
8. Altman R, et al. Hyaluronic acid injections are associated with delay of total knee replacement surgery in patients with knee osteoarthritis: evidence from a large U.S. health claims database.
9. Smith MM, Ghosh P. The synthesis of hyaluronic acid by human synovial fibroblasts is influenced by the nature of the hyaluronate in the extracellular environment.

Supports that may help

Knee cold compress

Cold and compression together can be a powerful way to calm an irritated knee. This easy-to-use knee wrap combines a reusable ice gel pack with gentle adjustable compression to help reduce swelling and ease discomfort after activity, injury, or arthritis flare-ups. Simple to freeze, quick to apply, and designed to comfortably support the knee when it needs it most.

£45

Order now

Ossur Formfit OA Knee

Who this is for: Early knee osteoarthritis, causing stiffness, swelling or reduced confidence during movement. Medical-grade compression with structured stability to help reduce knee pain and support comfortable, everyday activity without bulk.

£270

Order now

Össur Formfit® Tracker (PFJ)

Who this is for For kneecap pain, patellar tracking issues or instability affecting sport and daily movement. Adjustable, targeted patella support designed to guide the kneecap and improve comfort during activity, in a lightweight, breathable design.

£108

Order now

Össur Formfit® Pro Ankle

Who this is for For mild ankle sprains, instability or ligament irritation during recovery. Medical-grade compression with targeted ankle cushioning to reduce swelling and provide supportive stability without restricting movement.

£55

Order now

Össur Formfit® Pro Knee

Who this is for For general knee discomfort, mild instability or kneecap irritation affecting everyday movement. Gentle compression with targeted patella support to improve comfort and confidence during daily activity and exercise without restricting movement.

£60

Order now

Shop all supports