IGeL injection in the knee

Injections in the knee are supposed to slow down joint wear and tear and relieve pain. But the health insurance does not pay for hyaluronic acid injections for osteoarthritis of the knee. Is it worth the investment? We do the check

Osteoarthritis causes joint problems. Hyaluronic acid injections should help

© W & B / Michelle Günther

What is being done there?

Hyaluronic acid is a substance that occurs naturally in connective tissue. It also forms an important part of the synovial fluid. In osteoarthritis, hyaluronic acid is injected directly into the knee joint and is supposed to relieve symptoms, especially pain. How the injection works is not yet fully understood.

"It probably influences pain receptors," says Johannes Stöve, Professor of Trauma Surgery and Orthopedics at St. Marien Hospital in Ludwigshafen. It can also improve the lubricating properties of synovial fluid.


  • In some studies, patients report that the injections reduce the pain in the knee and make it easier to move around in everyday life.
  • In the current treatment guideline for osteoarthritis of the knee, the majority of the experts spoke out in favor of hyaluronic acid injections for patients who should not take pain relievers or who do not receive sufficient help from the medication.
  • You can't avoid an artificial knee joint, but you can sometimes postpone the operation.


  • Under certain circumstances, a syringe into the joint can introduce germs there and cause an infection.
  • Possible side effects also include allergic reactions. This is rare with modern preparations that are used in Germany - but it is better to inquire beforehand.
  • An effect is not guaranteed. The injections will not work for every patient.
  • The pain relief does not last. The injections have to be given again after about half a year to a year.


An injection with advice, examination and local anesthesia costs between 18 and 42 euros, plus the cost of the hyaluronic acid preparation itself. Around five syringes are necessary to achieve an effect. The expenses amount to around 250 to 300 euros.


Injections into a joint should be considered carefully. Because the advantage is always offset by a certain risk of unnecessary joint infection. However, osteoarthritis is so far not curable and the suffering is great among those affected. Therefore, the syringes can still be an option in therapy, emphasizes Dr. Christoph Eichhorn from the German Association of Orthopedists and Trauma Surgeons - ideally integrated into a broad treatment concept.

"Clinical experience shows that patients can definitely benefit from this." Professor Stöve from Ludwigshafen sees hyaluronic acid more as a possibility if physical and exercise therapy, weight reduction and pain medication do not bring any improvement: "Only then is an attempt with hyaluronic acid injections possible."