Knee arthritis can make walking, exercise, shopping, work, and stairs more difficult. When pain and stiffness continue despite physical therapy, medication, or activity changes, injections may be considered as part of a non-surgical treatment plan.
Two common options are cortisone injections and viscosupplementation. Patients often ask which one is better. The answer is that neither treatment is best for everyone. The most appropriate option depends on the type and severity of knee arthritis, the patient's health history, previous treatments, and treatment goals.
We provide individualized knee arthritis care for patients in Boca Raton, Boynton Beach, Delray Beach, and surrounding South Florida communities.
What Is a Cortisone Injection?
A cortisone injection is used to help reduce inflammation within a painful joint. It may be considered for patients with arthritis-related pain, swelling, or irritation that is limiting movement.
For some patients, cortisone can provide short-term relief that makes it easier to participate in physical therapy, return to daily activities, or manage a flare of symptoms. The response varies from person to person.
Cortisone injections are not designed to rebuild cartilage or cure knee arthritis. They are one tool that may be used within a broader treatment plan.
What Is Viscosupplementation?
Viscosupplementation is an injection treatment that uses hyaluronic acid for knee osteoarthritis. Hyaluronic acid is naturally present in joint fluid and contributes to lubrication inside the knee.
In an arthritic knee, the quality and amount of joint fluid may be reduced. Viscosupplementation is intended to supplement the knee's lubricating environment and may provide gradual symptom relief for selected patients.
We perform viscosupplementation injections in the office using ultrasound guidance to support accurate placement in the knee joint.
Is Viscosupplementation Better Than Cortisone?
Viscosupplementation is not automatically better than cortisone, and cortisone is not automatically the right treatment for every patient. They have different purposes and may be used at different stages of knee arthritis care.
Cortisone is commonly used when inflammation and swelling are major concerns. Viscosupplementation may be considered when a patient has knee osteoarthritis and has not experienced enough relief with other non-surgical options.
Some patients may not be ideal candidates for steroid injections because of their health history. For example, patients with diabetes may need to discuss how a cortisone injection could affect blood sugar management. In these cases, viscosupplementation may be discussed as another option.
How Does Viscosupplementation Work?
Viscosupplementation involves injecting hyaluronic acid directly into the knee joint. The goal is to improve the lubricating properties of the joint fluid and support smoother knee movement.
Depending on the product selected and insurance coverage, treatment may involve a single injection or a series of injections over several weeks. Dr. Toole will explain the recommended schedule based on the patient's diagnosis and the injection product available.
Symptom relief from viscosupplementation is generally gradual. Some patients notice improvement over the course of treatment, and benefits may last for several months. Results vary from patient to patient.
What Conditions Can Viscosupplementation Treat?
Viscosupplementation is FDA-approved for osteoarthritis of the knee. It is not FDA-approved for arthritis in other joints or areas of the body.
The treatment may be considered for patients with knee pain and knee arthritis who have not received sufficient relief from physical therapy, oral anti-inflammatory medication, activity changes, or other non-surgical care.
A full examination and review of X-rays can help determine whether knee arthritis is the source of symptoms and whether viscosupplementation may be appropriate.
What Happens During a Viscosupplementation Appointment?
The injection is performed in the office. Ultrasound guidance is used to help place the medication accurately into the knee joint.
Patients may feel mild discomfort during the injection. Temporary pain, swelling, warmth, redness, or stiffness can occur afterward. Ice packs and medication may be used as directed for post-injection soreness.
Patients are generally advised to avoid strenuous exercise, jogging, or sports for a short period after treatment. Your physician will provide specific activity instructions based on your condition.
When Might Cortisone Be Considered?
Cortisone may be considered when inflammation is contributing to knee pain and swelling. It can be useful for some patients who need short-term symptom management or are trying to participate more comfortably in rehabilitation.
However, cortisone is not a permanent solution for arthritis. Patients should discuss how often steroid injections may be appropriate and whether another treatment option could better support their goals.
Other Non-Surgical Knee Arthritis Treatments
Injection treatment is only one part of knee arthritis care. Depending on the patient's condition, a treatment plan may also include physical therapy, strengthening exercises, weight management, activity modification, supportive bracing, medication, PRP therapy, or other orthobiologic options.
When knee arthritis becomes advanced and continues to limit daily life despite appropriate non-surgical care, a surgical consultation may be recommended.
Frequently Asked Questions
Q. How long does viscosupplementation relief last?
Results vary. Some patients experience gradual relief that may last for several months, while others may not experience significant improvement.
Q. Is viscosupplementation covered by insurance?
Coverage depends on the patient's insurance plan and the specific injection product. The office can help patients understand their coverage and authorization requirements.
Q. Does viscosupplementation hurt?
Patients may feel mild discomfort during or after the injection. Temporary swelling, warmth, or stiffness can occur for a short time.
Q. Can I receive cortisone and viscosupplementation injections?
Your physician will determine whether either injection is appropriate and when it can be safely administered. The treatment plan should be based on your diagnosis, symptoms, and medical history.
Q. Will injections eliminate the need for knee replacement?
Not necessarily. Injections may help manage symptoms for some patients, but they do not reverse advanced arthritis or guarantee that surgery will not be needed in the future.
Dr. William P. Toole, MD, FAAOS is a board-certified, fellowship-trained orthopedic surgeon and sports medicine specialist serving patients across Boynton Beach, Boca Raton, Delray Beach, and the greater Palm Beach County area. A graduate of the honors college at Clemson University, Dr. Toole earned his medical degree with honors from the University of South Carolina School of Medicine and completed his orthopedic surgery residency at the University of Florida / Mayo Clinic Florida — one of the most respected training programs in the country. He is certified by the American Board of Orthopaedic Surgery, a Fellow of the American Academy of Orthopaedic Surgeons (FAAOS), and a member of the American Orthopaedic Society for Sports Medicine.
Prior to establishing his Florida practice, Dr. Toole served as Assistant Team Physician for four major professional sports franchises, the Houston Texans (NFL), the Houston Astros (MLB), the Houston Rockets (NBA), and the Houston Dynamo (MLS), bringing elite-level orthopedic experience to every patient he treats today. He specializes in arthroscopic and reconstructive surgery of the shoulder and knee, ACL reconstruction, rotator cuff repair, cartilage restoration, MACI procedures, and outpatient joint replacement, all performed using the latest minimally invasive techniques designed to get patients back to peak performance as quickly and safely as possible.
