Hyaluronic Acid (HA) Injections in Central London

✔ Non-steroid injection option

✔ Ultrasound-guided precision

✔ Joint & tendon sheath applications

✔ Central London clinics

What Is Hyaluronic Acid and Why Is It Used in Musculoskeletal Medicine?

• Hyaluronic acid (HA) is a naturally occurring polysaccharide found throughout connective tissue in the body. It exists in particularly high concentrations inside synovial joints and tendon sheaths, where it contributes to lubrication, shock absorption, and smooth tissue gliding.

• In osteoarthritis and certain chronic tendon conditions, the mechanical and biological environment of the tissue changes. Synovial fluid loses some of its viscoelastic properties. Tendon sheaths can become thickened and irritated. Friction increases. Movement becomes painful.

• Viscosupplementation involves injecting hyaluronic acid into the affected joint or sheath to restore more normal mechanical behaviour and support tissue function. Scientific reviews describe HA as working primarily by restoring viscoelasticity, with additional potential biological effects on inflammatory pathways within the joint environment.

• Hyaluronic acid does not regenerate cartilage or reverse arthritis. It is a non-surgical strategy designed to improve comfort, reduce stiffness, and support function in appropriately selected patients.

The Science Behind Hyaluronic Acid Injections

The viscoelastic properties of healthy synovial fluid depend heavily on molecular weight and structure of hyaluronic acid. In osteoarthritis, both concentration and molecular weight reduce, altering lubrication and shock absorption.

Research reviews describe HA as:

• Restoring viscoelastic function within synovial fluid

• Reducing mechanical friction

• Potentially modulating inflammatory mediators such as PGE2 and NF-kB

• Influencing matrix metalloproteinase activity

Evidence across systematic reviews is mixed but generally demonstrates symptom improvement over placebo in many patient groups. Some analyses suggest medium-term benefit comparable to or longer than corticosteroids in selected patients, though guideline bodies differ in their recommendations.

Importantly, hyaluronic acid has a generally favourable safety profile, with adverse events typically mild and local (temporary swelling, soreness, or reactive flare).

This is not a “miracle injection.” It is a structured mechanical intervention within a broader management strategy.

Commercial Brands of Hyaluronic Acid

Ostenil® Range – Structured Application by Tissue Type

Ostenil® is a well-established hyaluronic acid product line with variations tailored to different anatomical and mechanical requirements.

Ostenil® Plus  

Plus contains hyaluronic acid combined with mannitol, which helps stabilise the molecule and reduce oxidative degradation within the joint.

Typically used for medium - large joints such as knee, ankle, elbow and wrist osteoarthritis.

The goal is sustained viscoelastic support within synovial joints, particularly where symptoms have persisted despite rehabilitation.

Ostenil® Tendon

Ostenil Tendon is formulated specifically for peritendinous and tendon sheath applications, rather than intra-articular use.

It may be considered in:

Achilles Tendon disorders

Shoulder subacromial pain

Other selected degenerative tendon presentations

In these cases, the aim is to improve glide and reduce mechanical friction rather than alter joint mechanics.

This is distinct from steroid tendon sheath injections and may be appropriate in patients wishing to avoid repeated corticosteroid exposure.

Ostenil® Mini

Ostenil Mini is designed for small joint applications, where lower volume and targeted placement are required.

Common uses include:

Big toe 1st MTP joint osteoarthritis

Thumb 1st CMC joint osteoarthritis

MCP joint osteoarthritis of the fingers

AC joint pain in the shoulder

These smaller joints require high precision, and ultrasound guidance is especially important.

Durolane® – High Molecular Weight Option for Larger Joints

Durolane® is a stabilised, cross-linked hyaluronic acid formulation typically delivered as a single-injection treatment, primarily used in larger joints such as the hip.

It is often selected when:

A high molecular weight product is indicated

Large joint viscoelastic restoration is the goal

Clinical reviews describe Durolane as effective and generally well tolerated, with improvements reported in pain and function in knee osteoarthritis populations.

I typically reserve Durolane for larger joints where volume and sustained mechanical support are priorities.

How much does a hyaluronic acid injection cost?

A full consultation which includes the following is charged at £280.00:

• Clinical assessment

• Ultrasound guidance

• Injection procedure

• Aftercare guidance

The costs of purchasing the syringes are as follows and will be charged in addition to the £280.OO

• Ostenil Mini +£35.00

• Ostenil Plus/ Tendon +£75.00

• Durolane +£120.00

There are no hidden extras.

Are Hyarulonic Acid Injections Available on the NHS?

Hyaluronic Acid injections are very rarely available on the NHS in spite of being used across the world routinely in public health systems for musculoskeletal pain conditions.

If you’d like to explore whether a Hyaluronic Acid is appropriate for your joint or tendon condition, you can book a consultation below.

This includes clinical assessment and ultrasound evaluation to confirm suitability.