Hyaluronic Acid Injections

What is a Hyaluronic Acid?

Hyaluronic acid is a naturally occurring substance found in the synovial fluid of healthy joints. It acts as a lubricant and shock absorber, allowing joints to move smoothly and comfortably. As joints degenerate—due to osteoarthritis, injury, or wear and tear—HA levels reduce, contributing to stiffness and pain. Injecting HA directly into the joint can help restore balance and function.

Our injections use synthetic forms of hyaluronic acid—laboratory-produced formulations that are highly purified and designed to closely replicate natural HA. These are biocompatible, stable, and provide therapeutic benefits both mechanically and biologically. Importantly, studies show that synthetic HA injections can stimulate the joint’s own production of natural hyaluronic acid, helping to promote longer-term joint health beyond the life of the injected molecules.

Why Choose iPS Physiotherapy?

• Ultrasound-guided precision from a qualified specialist
• Personalised treatment planning in a comfortable South Wales clinic
• Flexible choice between Durolane and Ostenil Plus
• Options for HA, PRP, and cortisone based on your needs

Whether you're managing early osteoarthritis or looking for alternatives to surgery or steroids, our HA injection service offers a powerful and proven option.

Now Offering: Durolane and Ostenil Plus

At iPS, we now offer a choice of two leading synthetic hyaluronic acid injection products. Both products are ultrasound-guided, ensuring precise delivery and minimal discomfort.

Durolane

• Volume: 3 ml
• Concentration: High (single-injection formulation)
• Key Features: Longer-lasting formulation, ideal for those managing more advanced symptoms.
• Molecular Duration: Durolane uses NASHA™ technology to stabilise the HA molecules, allowing them to remain active in the joint for several weeks.
• Pain Relief Duration: Clinical studies and manufacturer data suggest Durolane can provide up to 6 months of symptom relief, with some patients benefiting for up to 12 months from a single injection.

Ostenil Plus

• Volume: 2 ml
• Concentration: Moderate
• Key Features: Effective for mild to moderate symptoms; includes mannitol, an antioxidant that protects HA from premature breakdown.
• Molecular Duration: Ostenil Plus typically remains in the joint for several days to two weeks, though its biological effects may continue longer.
• Pain Relief Duration: The manufacturer reports symptom relief for up to 6 months in suitable cases of mild to moderate knee osteoarthritis.
• Cost: A more budget-conscious option, especially appropriate for early-stage osteoarthritis or patients exploring HA therapy for the first time.

Which One Should I Choose?

Both Durolane and Ostenil Plus are evidence-based, synthetic HA products, but there are some important differences:

Durolane

• Molecular Persistence: Several weeks (NASHA-stabilised)
• Pain Relief Duration (claimed): Up to 6 months, sometimes longer
• Injection Frequency: Typically single-dose
• Ideal For: Moderate to advanced OA, longer-lasting needs
• Cost: Higher

Ostenil Plus

• Molecular Persistence: Several days to ~2 weeks
• Pain Relief Duration (claimed): Up to 6 months
• Injection Frequency: May be repeated depending on response
• Ideal For: Mild to moderate OA, first-time users
• Cost: Lower

We’ll guide you during your consultation to determine the most appropriate option based on the severity and stage of your joint condition, your previous treatment responses, budget and treatment goals and whether you prefer single or repeat injection strategies.

What’s the Evidence for Other Joints?

While hyaluronic acid is most commonly used for knee osteoarthritis, there is growing evidence to support its use in other joints when guided by ultrasound and applied to appropriate cases:

Hip Joint

• Moderate evidence suggests HA injections can reduce pain and improve mobility in hip osteoarthritis
• Ultrasound guidance is essential for precision
• Suitable when cortisone is contraindicated or surgery is to be delayed

Ankle Joint

• Promising results in early osteoarthritis and post-traumatic arthritis
• Can help delay surgical intervention
• Ultrasound delivery enhances effectiveness due to joint complexity

Other Areas

Occasionally used for:

• Thumb (CMC) joint OA
• Shoulder OA or adhesive capsulitis

These are more specialist applications and would follow detailed assessment.

How Does Hyaluronic Acid Compare to PRP and Cortisone?

Hyaluronic Acid (HA)

• Best For: Mild to moderate osteoarthritis, especially knees
• Key Benefits: Restores lubrication, improves shock absorption, stimulates native HA production
• Considerations: Gradual onset, cumulative effect

PRP (Platelet-Rich Plasma)

• Best For: Tendon injuries, early OA, active individuals
• Key Benefits: Uses your body’s own healing cells to reduce joint pain and promote soft tissue healing
• Considerations: May require multiple sessions, more costly

Cortisone

• Best For: Acute inflammation or flare-ups
• Key Benefits: Rapid pain relief, anti-inflammatory
• Considerations: Short-term relief only; not ideal for long-term or repeated use if alternatives exist

We often recommend HA injections when patients are:

• Seeking longer-term symptom control without steroid use
• Looking for a well-tolerated and repeatable option
• Managing knee osteoarthritis or joint pain in the hip or ankle

Other options like PRP or cortisone may be more suitable depending on individual goals and symptoms—we’ll guide you through all appropriate choices.