An alternative to Steroid injections for pain relief from Hip and Knee Joint Osteoarthritis.
£350 per Durolane Injection inclusive of Assessment
What is Durolane?
Durolane is a purified form of Hyaluronic Acid. Hyaluronic Acid is a naturally occurring substance in joints. As joints age and become more arthritic the amount of Hyaluronic Acid present in the joint reduces. There is evidence that injecting Durolane into Arthritic Knee and Hip joints can give relief for up to 6 months.
Who are Durolane Injections appropriate for?
Durolane is appropriate for mild to moderate joint osteoarthritis, most commonly used in knees and hips but also commonly used for shoulder, elbow, wrist, fingers, and toes arthritis
Steroid Injection versus Durolane Injections?
Both procedures are Ultrasound Guided to improve accuracy. There are potential benefits and drawbacks with both injections. Some of these are summarised below.
| Durolane Injections | Steroid Injections |
| Evidence for mild to moderate Osteoarthritis. | Can be used in mild, moderate or severe Osteoarthritis. |
| Replicates naturally occurring substance in the body and minimal side effects from Durolane (see below) | Is a drug – though risks are low there are more known potential side effects Steroid Injection Leaflet. |
| May take longer to start working – within 2 weeks but may be longer lasting. | Likely to be faster acting – within 1 week. |
| Can be repeated every 6 months if effective. | Can be repeated every 3 months if effective. |
| Indicated if knee is painful but not swollen. | More likely to be effective if knee is inflamed and swollen due to anti-inflammatory nature of Steroids |
How Does Durolane work?
Risks and Side-Effects of Durolane Injections
Risks of injections are broadly divided into:
- the act of injecting something into the body
- Infection – very unlikely due to the steps taken in our injection procedure.
- Trauma from the needle causing temporary bruising or pain.
OR
- the action of the substances/medications being injected
- allergic reaction – extremely rare
- other unwanted effects of the medication injected in addition to pain relief. Durolane has very few known side effects – most common in studies were temporary pain, swelling and/or stiffness localized to the joint.
Durolane is a purified, synthetically made form of a substance (Hyaluronic Acid) naturally occurring in the body. The risk of allergies and side effects therefore are very low. The risks associated with injecting (putting a needle through the skin) however, cannot be avoided. Infection is a very rare risk and is mitigated by the use of clean injection technique. Trauma resulting from the injection is unavoidable and may result in short-term increased pain, bruising or swelling. The risk of injections is generally very low but it is good to be aware of the risks. These will be discussed with you before any procedure.
For a more detailed description of the risks associated with injections please see our Steroid Injection Leaflet
How Does Durolane work?
Durolane is a fairly thick substance that mimics the naturally occurring Hyaluronic Acid in your joints. When you have Osteoarthritis the levels of Hyaluronic Acid in the affected joint is lower. Durolane injections temporarily replenish the levels of Hyaluronic Acid in the affected joint. It is thought to act as a lubricant and shock absorber to the joint, thereby reducing symptoms of pain and stiffness associated with Osteoarthritis.
Why is a Durolane Injection more expensive than a Steroid Injection?
Quite simply Durolane is approximately £100 more expensive for us to purchase than steroid per dose. The technical skill and injection procedure is the same for each type of injection.
What Should I Do after a Durolane Injection?
Physiotherapy – after any post-injection soreness has settled and the pain has started to reduce. At this point improving flexibility and strength of the hip or knee and working on general leg strength is recommended (NICE Guidelines) to maximise the effectiveness of the injection.
How do I choose which is best for me?
There is no right or wrong answer. On balance there are likely more potential side effects with steroid injections, but the effects of steroid injections may be felt sooner. So if you would prefer to avoid a drug treatment, then Durolane may be worth considering first as a more ‘natural intervention’, particularly if your arthritis is mild or moderate. Steroid injections can be used as an alternative if Durolane is not as effective as hoped. If your arthritis is more severe or there is significant swelling associated with the pain, indicating inflammation, a steroid injection may be more appropriate.
Can I try a Durolane Injection first and then if not effective try a steroid Injection?
Yes this is perfectly reasonable.
Can Durolane Injections be repeated?
Durolane injections can be repeated 6 monthly if effective. If ineffective then steroid injections can be considered as another option to help relief symptoms.