Ultrasound Guided
Hyaluronic Acid Injections

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For treating weight-bearing joints, Hyaluronic Acid Durolane is often preferred over Ostenil Plus because it tends to last longer. Durolane is a viscosupplement used in the management of osteoarthritis—a degenerative condition marked by cartilage deterioration and joint inflammation. As a highly cross-linked hyaluronic acid (HA) formulation, it provides a safe and effective option for reducing pain and improving mobility in affected individuals.

Composition of Durolane

Durolane contains stabilised hyaluronic acid produced through fermentation from non-animal sources. Naturally present in synovial fluid, hyaluronic acid helps lubricate joints, cushion movement, and absorb impact. In Durolane, the HA is carefully purified and cross-linked using a specialised process, forming a gel-like substance with increased durability and longer retention within the joint.

Highly Cross-Linked Hyaluronic Acid:

One of Durolane’s defining characteristics is its extensive cross-linking. This process chemically binds hyaluronic acid molecules together, enhancing the gel’s thickness and strength. As a result, several benefits arise:

  • Greater durability: Its structure allows it to resist mechanical stress and maintain effective lubrication and cushioning.

  • Extended presence in the joint: The enhanced stability means it remains active for longer, reducing the need for repeated injections.

  • Reliable effectiveness: The consistent structure supports predictable outcomes, improving symptoms and joint function in patients with mild to moderate osteoarthritis.

Benefits of Durolane

Durolane offers multiple advantages for managing osteoarthritis:

  • Pain reduction: By restoring hyaluronic acid levels, it improves joint lubrication and reduces discomfort.

  • Better joint performance: It enhances flexibility and mobility, making everyday activities easier.

  • Low risk of side effects: Compared to corticosteroids, Durolane has minimal adverse effects and is generally well-tolerated due to its non-animal origin.

  • Long-lasting relief: Its cross-linked composition allows symptom improvement to last up to six months or longer after a single injection.

Durolane Injection Procedure

The injection is typically performed under ultrasound guidance to ensure precision. The process generally includes:

1. Preparing the patient and cleaning the injection area

2. Using ultrasound imaging to assess the joint and locate the ideal injection site

3. Applying local anaesthesia to reduce discomfort

4. Inserting a sterile needle into the joint space with imaging guidance

5. Injecting the Durolane gel into the joint

6. Advising post-procedure care, including rest and gradual return to activity

Conclusion

Durolane is an effective treatment option for individuals with osteoarthritis who experience joint pain and reduced mobility. Its advanced cross-linked hyaluronic acid formulation, combined with precise injection techniques, provides sustained relief and improved joint function, ultimately supporting a better quality of life.

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Frequently Asked Questions

  • Hyaluronic Acid (HA) injections, also known as viscosupplementation, provide additional joint lubrication to improve mobility and reduce pain associated with mild to moderate osteoarthritis. Hyaluronic Acid is a naturally occurring gel-like substance in healthy joints that cushions and absorbs shock.

  • This treatment is commonly recommended for:

    • Mild to moderate knee osteoarthritis

    • Hip, shoulder & ankle osteoarthritis

    • Joint stiffness and reduced movement

    • Pain that worsens with activity, sport or walking

  • As arthritis progresses, natural HA levels decline. Replacing it through injection restores lubrication, reduces joint friction, improves cushioning, and allows smoother movement - helping decrease pain and increase function.

  • At the Private Injection Clinics, we offer three trusted types of hyaluronic acid injections to help relieve joint pain and symptoms of osteoarthritis. These are Ostenil Plus, Durolane, and Biolevox HA ONE/SmHArtfix One (the same product supplied under two different names).

    Each type of hyaluronic acid works slightly differently. Some last longer in the joint, while others are better suited to earlier stages of joint wear. This allows us to choose the most suitable injection based on the joint being treated, the level of osteoarthritis, and your individual symptoms.

    Ostenil Plus

    • Contains hyaluronic acid with an added ingredient that helps it last longer in the joint

    • Improves joint lubrication and movement

    • Commonly used for mild to moderate knee osteoarthritis

    • Can help reduce pain, stiffness, and swelling

    • Often chosen for patients wanting steady, gradual pain relief

    Durolane

    • A stronger, thicker form of hyaluronic acid

    • Given as a single injection

    • Designed to stay in the joint for longer

    • Often used for moderate to more advanced osteoarthritis

    • Suitable for patients wanting longer-lasting relief with fewer injections

    Biolevox HA ONE/SmHArtfix One

    • The same hyaluronic acid product, supplied under two different brand names

    • Helps cushion and support the joint

    • Suitable for knees, hips, and other joints

    • Offers a good balance between comfort, strength, and duration

    • Commonly used for ongoing joint pain relief

  • There is no single hyaluronic acid injection that is right for everyone. The best option depends on:

    • Which joint is being treated

    • How severe the osteoarthritis is

    • Your pain levels and activity level

    • How you have responded to injections in the past

    Your clinician will assess your condition and recommend the most suitable hyaluronic acid injection to help reduce joint pain and improve movement.

  • Yes - HA injections are ultrasound-guided to ensure the treatment is placed directly inside the joint for maximum effectiveness.

  • Results typically last between 4 and 12 months, depending on the individual and severity of joint changes. Repeat treatment can be scheduled when symptoms return.

  • Most patients report minimal discomfort - it is a quick procedure and well tolerated. Temporary pressure or mild soreness may occur but settles quickly.

  • You may benefit if you:

    • Have symptoms of mild to moderate osteoarthritis

    • Have not found adequate relief from physiotherapy or medication

    • Are seeking a non-surgical option before knee replacement

    • Prefer a steroid-free approach

  • See Table 1 below.

  • Patients commonly notice:

    • Reduced pain and stiffness

    • Easier walking and exercise

    • Better range of motion

    • Gradual improvements over weeks

  • Hyaluronic Acid may not be recommended if:

    • You have a joint infection

    • You have an allergy to HA products

    • You have severe bone-on-bone arthritis

    Suitability is reviewed at consultation.

Resources

Hyaluronic Acid Steroid
Lubrication & shock-absorption Anti-inflammatory
Longer-lasting (4–12 months) Short-term relief (weeks–months)
Ideal for mild to moderate OA Best for acute flare-ups
Does not weaken cartilage Repeated use may weaken tissue

Table 1: Hyaluronic Acid vs. Steroid Injections