Treatments
Viscosupplementation
Hyaluronic acid for joints with degeneration.
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It is a minimally invasive procedure: a viscosupplement is placed inside the joint to improve lubrication and modulate osteoarthritis symptoms in selected patients. It is not surgery. It does not replace an evaluation.
What it is
Viscosupplementation consists of injecting hyaluronic acid (or an equivalent preparation) into a joint, most often the knee. Hyaluronic acid is part of healthy synovial fluid; in osteoarthritis that quality and quantity change.
The usual clinical aims are:
- To reduce pain associated with joint degeneration
- To improve the sense of mobility and “lubrication”
- To support a conservative plan when surgery is not yet indicated, or when the patient is not a surgical candidate
Recovering movement, when it happens, is recovering quality of life. That does not occur in every case or in a single visit.
How it differs from prolotherapy
They are different tools and are sometimes combined.
| Viscosupplementation | Prolotherapy | |
|---|---|---|
| Where it acts | Mainly inside the joint (fluid and cartilage/synovium) | Ligaments, tendons, entheses and, depending on the protocol, the joint |
| What it aims for | Lubrication and relief in joint degeneration | A repair stimulus and stability |
| In her words | Symptom relief is not the same as regeneration | Regeneration is a process, not an event |
If the main problem is a lax ligament, hyaluronic acid alone does not resolve the instability. If the main problem is a compartment with advanced joint degeneration and stiffness, periarticular prolotherapy may not be enough.
More on prolotherapy and knee pain.
When it may be considered
- Knee osteoarthritis with pain and stiffness that limit daily life
- Joint degeneration in other large joints (hip, shoulder) when anatomy and clinical judgment allow it
- Patients who have already worked on joint hygiene, weight, strength and analgesics and still have symptoms
- As part of a regenerative protocol, not as the only procedure
It is not the first step in a locked, infected or frankly unstable knee, or when surgery is clearly indicated.
The number of applications depends on the joint being treated.
How it is done
Approach
Skin preparation. In clinic, ultrasound guidance is preferred when it adds safety and precision.
Placement
The viscosupplement is placed in the joint recess.
Aftercare
Activity advice for the following hours and days.
Before and after
Before the procedure, let us know which medications you take (especially blood thinners), and whether you have a bleeding disorder or allergies.
Afterward, the most important thing is not to overload the joint: too much effort can irritate the treated area and slow recovery.
- Rest for the first 24–48 hours. Avoid demanding activities and repetitive movements.
- Stay active, but in moderation: light activities such as easy walking, as tolerated.
- Avoid overloading the area: lifting weights, strength training, running, jumping or impact, going up and down stairs too much, standing or squatting for long periods, high-impact sports, and twisting or sudden movements.
- Apply ice locally for 15–20 minutes, 2–3 times a day during the first 2–3 days.
- You can take acetaminophen (paracetamol) if you need it. Anti-inflammatories are not recommended unless a doctor indicates them.
- Drink enough water during the day.
- After the first few days, gentle stretching as your doctor indicates, and, if there is no pain, a stationary bike at an easy pace, swimming, and light mobility and balance exercises.
A mild inflammation or discomfort is normal. Every body is different and recovery times vary. If fever, redness, significant warmth or swelling appear, or severe pain that gets worse as the days go by, seek medical attention right away.
In short, in an infographic by Dr. Lizeth Ortiz:
View largerWhat it does not promise
It does not reliably “regrow cartilage”. It does not cure osteoarthritis. It does not replace a joint replacement when that operation is indicated. Results vary with grade of joint degeneration, alignment, weight, muscle strength and expectations.
Frequently asked questions
What is the difference between prolotherapy and viscosupplementation (hyaluronic acid)?
They are different treatments that can complement each other. Viscosupplementation consists of placing hyaluronic acid inside the joint, mainly to improve the joint environment and help ease pain and discomfort associated with joint degeneration. Prolotherapy, by contrast, seeks to stimulate a repair response in structures such as ligaments, tendons and entheses. Entheses are the zones where these tissues attach to bone. In some patients, combining both therapies can be useful because it addresses both the joint itself and the structures that support and stabilize it. The combination and the number of applications depend on the injury, the symptoms and each patient’s evaluation. They do not do the same job, but they can complement each other within a personalized treatment plan.
Does the injection hurt?
Local anesthetic is used to reduce discomfort during the procedure. Even so, you may feel pressure, contact or mild discomfort. Before starting, we explain what you may feel and what aftercare to follow. Ultrasound allows the procedure to be done with greater precision, although it does not completely remove the sensation of the needle.
Are results guaranteed?
No. Results vary depending on the person, the tissue and what has already been tried. Expectations are reviewed honestly during the consultation.
What imaging do I need for the evaluation?
Ideally, X-rays of the painful area (knee, hip, shoulder, spine or other) taken within the last year. If you already have an MRI or ultrasound, those help too: share them on WhatsApp before your visit. If you do not have recent imaging, we tell you which studies to get before booking.
How much does the consultation cost? And the treatment?
The evaluation visit costs MXN $500 (Mexican pesos). Treatment (prolotherapy, viscosupplementation, injections or another procedure) has no fixed price: it depends on the area, the procedure and the number of sessions you need, which are decided at your evaluation. Before starting, we tell you the cost of your plan.
Book a visit
Care in Guadalajara and Mexico City, by appointment.
Guadalajara: Bari Medical Center, San Juan de Los Lagos 21, Vallarta Poniente, 44110 Guadalajara, Jalisco, Mexico. Monday through Saturday.
Mexico City: Medical San Francisco, Rosa María Siqueiros 229, San Francisco Culhuacán, Coyoacán, 04420 Mexico City, Mexico. One week a month; ask us for the dates on WhatsApp.
You don't need imaging to message us; if you need any, we'll tell you which.
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