Knee Osteoarthritis: When Cartilage Wears Away
Knee osteoarthritis (gonarthrosis) is one of the most common degenerative joint diseases in Germany. An estimated 5 million people in this country suffer from clinically relevant symptoms – pain when climbing stairs, morning stiffness, limited mobility. For a long time, the classic medical response was: painkillers, physiotherapy, and eventually a total knee replacement.
However, between conservative basic therapy and surgical intervention, there is an effective, minimally invasive option: intra-articular injection with hyaluronic acid, also known as viscosupplementation.
What is Viscosupplementation?
Healthy synovial fluid contains high molecular weight hyaluronic acid, which gives the joint its shock-absorbing and lubricating properties. In osteoarthritis, the concentration and quality of this endogenous hyaluronic acid decrease – the joint becomes drier, and the cartilage surface experiences more friction.
Viscosupplementation replaces or supplements this missing synovial fluid through the direct injection of exogenous hyaluronic acid. The result: reduced friction, improved shock absorption, and proven pain reduction.
Comparison of Hyaluronic Acid Preparations
Single-Shot Preparations (one injection)
Durolane 60mg/3ml – Bioventus' NASHA gel allows for a complete treatment in just one session with an effectiveness lasting up to 6 months. Read more: Durolane Single-Shot Guide.
Synvisc-One 48mg/6ml – Sanofi's Hylan G-F 20 offers maximum joint relief with a 6 ml volume. Read more: Synvisc-One Guide.
Monovisc 88mg/4ml – Highest HA concentration in one injection. Comparison: Durolane vs. Monovisc vs. Cingal.
Cingal 4ml – The only combination of HA + corticosteroid for immediate and long-lasting effects. Read more: Cingal Explained.
Multi-Injection Series
Ostenil Plus 40mg/2ml – Highly concentrated HA with mannitol antioxidant. Read more: Ostenil Plus Guide.
Orthovisc 30mg/2ml – Proven preparation for the 3-injection series, good value for money.
Which Patients Are Suitable for Treatment?
- Gonarthrosis Grade I–III according to Kellgren-Lawrence
- Insufficient response to NSAIDs or physiotherapy
- Contraindications to systemic pain therapy
- Patients who want or need to delay surgery
- Active patients with high functional demands – see also: Joint Injections in Sports Medicine
Studies and Evidence
Several meta-analyses and systematic reviews confirm the effectiveness of hyaluronic acid injections in knee osteoarthritis. ESCEO recommends hyaluronic acid injections as part of the stepped treatment plan.
Costs and Reimbursement
Information on costs and health insurance reimbursement can be found in our article: Joint Injection Costs & Reimbursement.
Practical Procedure
The injection is performed under sterile conditions, ideally ultrasound-guided. The procedure takes a few minutes and can be carried out on an outpatient basis. A complete overview of all preparations and indications: Which Preparation for Which Indication?
Order Now in the Novamedo Shop
Discover our complete range of hyaluronic acid joint injections – Durolane, Synvisc-One, Ostenil Plus and many other medical quality preparations with fast delivery.
