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ViscosupplementationHyaluronic acid injections to restore the lubricating properties of joint fluid in mild-to-moderate knee arthritis — a non-steroid option for patients deferring knee replacement, offered at Remix Medical in Houston, TX.

Specialty
Pain Management
Type
Procedure
Body location
Knee joint, tibiofemoral joint, synovial fluid, articular cartilage
CPT code
20610 (injection, major joint, without ultrasound), 20611 (with ultrasound guidance); HCPCS J-codes billed separately for the hyaluronan product administered (e.g. J7318, J7321, J7323, J7325, J7326, J7327 — varies by preparation)

Also known as: Hyaluronic Acid Injection, Gel Injection, Knee Gel Shot, Hyaluronan Injection, Intra-Articular Hyaluronic Acid

Viscosupplementation for Knee Arthritis in Houston, Texas

Healthy joint fluid is viscous. It cushions load and lubricates motion, and it owes those properties to hyaluronic acid. In an arthritic knee, the hyaluronic acid is degraded and the fluid becomes thin. Viscosupplementation replaces it.

What is Viscosupplementation?

Viscosupplementation is the injection of hyaluronic acid into the knee joint. It is given either as a single injection or as a series of three to five weekly injections, depending on the preparation used.

Unlike a corticosteroid injection, which suppresses inflammation, viscosupplementation aims to restore the mechanical properties of the joint fluid. The onset is slower and the effect, in patients who respond, tends to last longer.

An Honest Account of the Evidence

Viscosupplementation is one of the more contested interventions in orthopedics. Some large analyses report clinically meaningful benefit in mild-to-moderate knee osteoarthritis; others find effects that do not clear the threshold for clinical importance. Major professional societies differ in their recommendations.

What the evidence supports reasonably well: it is safe, it is best suited to mild-to-moderate disease, and it has little role in bone-on-bone arthritis. Patients with advanced structural change should be counseled toward other options rather than a series of injections that is unlikely to help.

We will tell you where you sit on that spectrum before you commit.

Who It Suits

  • Mild-to-moderate knee osteoarthritis on weight-bearing X-ray
  • Patients who cannot tolerate NSAIDs — including those with chronic kidney disease
  • Patients wanting to defer knee replacement
  • Patients whose corticosteroid response has become brief or has faded

Considering Your Options at Remix Medical

A candid conversation about what a treatment can and cannot do is worth more than an enthusiastic one. Contact Remix Medical to schedule a consultation with a board-certified pain management physician in Houston.

How it's performed

The knee is cleansed and the skin anesthetized. Under ultrasound guidance where indicated, a needle is placed into the joint space and any effusion is aspirated first, since excess fluid dilutes the injectate. A hyaluronic acid preparation is then injected into the joint. Depending on the product, this is repeated weekly for a total of one to five injections.

How to prepare

No fasting required. You may drive yourself. Disclose any allergy to eggs, poultry, or avian products, as some preparations are avian-derived. Bring recent weight-bearing knee X-rays. Insurance pre-authorization is commonly required and should be confirmed before the first injection.

What to expect after

Ice the knee 20 minutes every 2 to 3 hours for the first day after each injection. Avoid running, prolonged standing, and heavy lifting for 48 hours. Mild swelling or warmth in the first day or two is expected. Complete the full injection series as scheduled. Report a hot, red, acutely swollen knee with fever immediately.

Outcome

In appropriately selected patients with mild-to-moderate knee osteoarthritis, viscosupplementation may reduce pain and improve function for up to six months. Benefit is unlikely in advanced bone-on-bone disease, and patients are counseled accordingly before treatment begins.

Related

Learn more

Your physician

Your pain management at Remix Medical.

Every clinician at Remix Medical is board-certified and owns the practice — so the physician in your exam room is the one making decisions about your care.

  • Raju Mantena, DO

    Pain Medicine Physician

    Medical Center — South Freeway · Montrose — Upper Kirby · Pearland

    Board certifiedAccepting newBook

This page is for general education and is not a substitute for medical advice. Whether a given procedure is appropriate depends on your individual evaluation. Contact a Remix Medical clinician to discuss your care.

Updated July 9, 2026.

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