Living with knee pain from osteoarthritis (OA) can be incredibly frustrating. For many, daily activities like walking, climbing stairs, or standing for long periods become painful challenges. Not everyone will need to undergo a total knee replacement surgery. In fact, there are non-surgical orthopaedic treatments for knee pain without the risks and long recovery times of invasive procedures.
One such option growing in popularity is hyaluronic acid (HA) injections. In this article, we’ll explore how HA injections work, their benefits, and key differences between leading brands like Cingal, Monovisc, and Orthovisc. We’ll also cover what to expect after the injection, what to look for in a good HA product, and potential side effects.
UNDERSTANDING OSTEOPARHRITIS AND KNEE PAIN
Osteoarthritis is the most common type of arthritis, often affecting the knee joint. It occurs when the cartilage that cushions your joints breaks down over time, leading to pain, stiffness, inflammation, and reduced mobility. Some factors that increase the risk of OA include previous joint injuries, high impact activities, increasing age, female gender, obesity and pre-existing joint disease.
As OA progresses, the natural synovial fluid in your joint—rich in hyaluronic acid—loses its lubricating properties. This is where viscosupplementation (injection of HA into the knee joint) comes in.
WHAT IS VISCOSUPPLEMENTATION?
Viscosupplementation includes HA injections used to restore lubrication and cushioning in the knee joint. Hyaluronic acid is a naturally occurring substance in the body, especially in the synovial fluid of joints. When injected into an arthritic knee, it can help:
- Reduce friction between bones
- Improve joint mobility
- Decrease inflammation
- Provide pain relief
Ideal for Those Avoiding Surgery
HA injections are often recommended for people:
- Not ready for or afraid of surgery
- Who want to postpone joint replacements
- Who haven’t responded well to pain medications or physical therapy
- Seeking a middle-ground solution between conservative therapy and invasive surgery
WHY HYALURONIC ACID MOLECULAR WEIGHT AND SOURCE MATTER
Not all HA injections are the same. An ideal HA injection should contain high molecular weight HA from a non-animal source to reduce potential side effects and flare-ups.
Higher molecular weight HA tends to stay longer in the joint, offering greater cushioning and longer duration of pain relief, but this can vary by patient.
Non-animal derived HA has lower risk of allergic reactions while avian-based HA (from rooster combs) may trigger allergic or inflammatory responses in people sensitive to bird proteins. That’s why non-avian, bio-fermented HA products like Cingal, Monovisc, and Orthovisc are often preferred.
KEY DIFFERENCES BETWEEN CINGAL, MONOVISC AND ORTHOVISC
Cingal
- Dual-action formula: Contains the highest dose of high molecular weight HA (88mg) + a premium corticosteroid in a single injection
- Provides fast-acting pain relief (from the corticosteroid) and long-lasting joint lubrication (from the HA)
- Convenient one-time treatment to relieve OA symptoms up to 6 months
- Ideal for patients needing both immediate and sustained relief
- Suitable for patients with avian protein allergies
- Cingal is the first and only HSA and CE‑mark approved HA + corticosteroid combination injection for knee OA
- More than 1 million injections sold in more than 35 countries
Monovisc
- High molecular weight HA
- Single injection to relieve OA symptoms up to 6 months
- Ideal for patients seeking a low-risk, convenient option
- Suitable for patients with avian protein allergies
- Monovisc delivers the highest HA dose (88 mg) in a single injection
- More than 3 million injections sold internationally
Orthovisc
- High molecular weight HA
- Typically administered as a 3-injection series (once a week) for up to 6 months OA symptom relief
- Offers gradual improvement over time
- Suitable for patients with avian protein allergies
- Orthovisc delivers one of the highest HA concentrations (15 mg/ml) in a multi-injection treatment
- More than 30 million injections sold internationally
WHAT TO EXPECT AFTER AN HA INJECTION
Post-Injection Recovery Time:
- Mild transient swelling and discomfort at the injection site is common for 24–48 hours.
- Most patients resume normal activity like light walking the same day but should avoid strenuous activity for at least 48 hours.
- Pain relief may happen almost immediately, while it may take 1–2 weeks to for some patients and can last up to 6 months
Helpful Recovery Tips:
- Use ice packs for soreness
- Avoid high-impact exercise temporarily and putting too much weight on your knee(s)
- Follow your doctor’s rehab plan or physical therapy
ARE HA INJECTIONS RIGHT FOR YOU?
HA injections are a great option for:
- Mild to moderate knee osteoarthritis
- Patients who want to delay or avoid knee replacement
- Those not responding to oral pain meds
- People afraid of surgery or not candidates for surgery due to health issues
However, HA injections may not be as effective in:
- Severe OA with major joint deformity
- People with active infections or bleeding disorders
MAKING THE RIGHT CHOICE
If you’re suffering from chronic knee pain due to OA and looking for a non-surgical, low-risk treatment, HA injections can be a valuable part of your pain management plan. Brands like Cingal, Monovisc, and Orthovisc offer excellent symptom relief—with each tailored to different needs, from fast-acting pain control to long-lasting lubrication.
When choosing an HA injection, look for:
- Non-animal derived formulations (lower risk of reaction)
- Single vs. multi-injection protocols (for your convenience)
- A reputable clinic and experienced injector
Cingal, Monovisc, and Orthovisc are widely available across major hospitals, orthopaedic centres, and GP clinics throughout Singapore — speak to your doctor today to find out which treatment best suits your lifestyle and take the first step toward lasting relief from knee pain.