Injections are used to help in the management of osteoarthritis, but they are not a cure for the condition. They act by reducing symptoms such s pain and discomfort with the aim of improving function once more. As with other medicines, they should be used as a package, for example, alongside exercising or physiotherapy. The injections that we will cover in this article are called intra-articular injections – injections directly into the joint itself. They are therefore very different to the usual intramuscular injections (e.g. the flu jab) or subcutaneous injections (e.g. those used to administer insulin). There are two intra-articular injections commonly used in the management of osteoarthritis:

  • Corticosteroid injections
  • Hyaluronic acid

We will discuss these two injections and look at how effective they are, who they are suitable for, and potential side effects.

Corticosteroid intra-articular injections

Corticosteroids are hormones that are either produced naturally by the adrenal gland (found above the kidney) or produced synthetically. Most injection preparations are synthetic. They have various metabolic functions, but are used in osteoarthritis because of their potent ability to reduce inflammation. They were first used in the 1950s and to date most studies have concentrated on the knee joint, although there are some indications that it may also be beneficial for the hips. The vast majority of the research conducted with the knee joints confirms that corticosteroid injections are beneficial when compared to a placebo treatment. Today approximately 53% of doctors use these injections to help alleviate pain caused by osteoarthritis.

As mentioned earlier, the corticosteroid injection is not a cure for osteoarthritis but it can help relieve the pain and inflammation. The onset of pain reduction is usually rapid (between 24-48 hours) with the maximum effect being reached within a few days. Studies have shown that the benefits last up to 4 weeks in most subjects and up to 3 months in some patients who have effusions of the knee. They can be repeated up to four times per year for the knee joint although usually less often for hand joints. Research to date has not shown repeated injections to cause any deterioration of osteoarthritis in humans.

It is not uncommon following the injection to have a temporary, mild flare-up of knee pain occasionally accompanied by some inflammation. This is due to a natural reaction of the synovial fluid in the joint to the crystal steroid solution of the injection. It is usually an immediate side effect but it is not permanent, and the treatment for this is a cold compress.

Hyaluronic acid

Hyaluronic acid is a naturally occurring component of the synovial fluid and is also found in the cartilage. It is highly viscous and acts as a shock absorber within the joint. It also stores energy that can be released when there is rapid joint movement and acts as a lubricant when there is slower movement. It is thought it has a role in maintaining a healthy cartilage. In the osteoarthritic joint there is less naturally occurring hyalronic acid and it can be less viscous.

By injecting hyaluronic acid directly into the joint the depleted levels are replenished and hence ease the pain and improve function of the joint.

Hyaluronic acid injections are not a cure for osteoarthritis,but they are used to help reduce the symptoms  (pain, swelling, stiffness). The benefits are usually noticed between 2 to 5 weeks, although this can vary. The benefits usually last about 6 months.

Please call +65 64712674 for an appointment to see our orthopaedic surgeon to treat osteoarthritis today.

Learn More About Viscosupplements

What is a viscosupplement?

A viscosupplement is a type of fluid that is injected directly into the knee to help lubricate and cushion the joint. Viscosupplements replace damage synovial fluid to help relieve pain and improve joint function.

What are viscosupplements made from?

Viscosupplements are made from a substance called hyaluronan. Hyaluronan is a natural substance found in the body and is present in very high amounts in joints. The body’s own hyaluronan acts like both a lubricant and shock absorber in the joint and is needed for the joint to work properly.

When should I consider a viscosupplement?

Viscosupplements are for people with Osteoarthritis of the knee who have not received enough pain relief from diet, exercise, and pain medication. If you’ve tried these options and are still feeling pain, ask our doctor if a viscosupplement could help.

What are the side effects?

Side effects with viscosupplements may include pain, swelling, or fluid build-up around the knee.

Knee Osteoarthritis Synvisc Treatment
Knee Osteoarthritis Synvisc Treatment

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Prepare for your appointment

Be informed about viscosupplements

Who administers viscosupplement injections?

Our orthopaedic surgeon, Dr Kevin Yip.

How are viscosupplements given?

Viscosupplements are injected directly into the knee. Depending on the type of viscosupplement you receive, it may be given as a series of injections or as a single injection.

What is the procedure like?

Each injection takes a few minutes and can be given in our doctor’s office.

Will the injection hurt?

Our doctor will apply a numbing agent before your viscosupplement injection. You may feel some pressure, but is should not be painful.

What happens after the injection?

You can resume your normal day-to-day activities immediately after the injection, but you should avoid any strenuous activities for about 48 hours.

Call +65 6471 2674 today for an appointment with our doctor today.


Autologous Platelet Rich Plasma, a new approach for healing muscle and ligament injuries.


What is Autologous Platelet Rich Plasma Therapy?

Autologous platelet rich plasma therapy (PRP) is a promising solution to accelerate healing of tendon injuries and osteoarthritis naturally without subjecting patients to significant risk. The philosophy is to merge cutting edge technology with the body’s natural ability to heal. PRP technology was intially developed 20 years ago to aide with wound healing and blood loss. Its benefits are now applied towards the facilitation of healing tendons and cartilage. In fact, PRP has been widely used for years in Europe to treat various tendon injuries.

How does PRP procedure work?

Using the patient’s own blood, specially prepared platelet are taken and then re-injected into the affected area. These platelets release substances known as “growth factors” that lead to tissue healing. For example, when you cut yourself, the body’s natural response is to attract platelets that release growth factors and facilitate healing. By concentrating the platelets we increase the release of growth factors which promotes the healing of tendons and cartilage.

The human body has remarkable ability to heal itself and by re-injecting concentrated platelets we are facilitating the natural healing process.

Is Platelet Rich Plasma Right For Me?

For most patient PRP offers a solid, alternative treatment for those who do not wish to have surgery. An initial evaluation will determine if PRP is a viable treatment option.

What are the benefit of PRP treatment?

Patients can expect to see significant improvement in symptoms; elimination of need for more traditional treatments such as medications, cortisone inceptions or surgery; and a dramatic return for function.

How soon can I go back to regular physical activity?

This treatment is not “quick fix” and is designed to promote long-term healing. The process of PRP requires time and rehabilitation. Patients who follow a course of physical therapy are likely to see the most improvement in the affected area. PRP accelerates and shortens the recovery process in chronic injuries and new acute injuries.

Prior studies on tennis elbow have demonstrated an 81% improvement in pain scores at six months and 93% reduction in pain follow up at 1-3 years.

Through regular follow-up visits your doctor can determine when you are able to resume regular physical activities.

How do I prepare for an injection?

Patients should schedule an evaluation to determine if PRP is a viable treatment option. An MRI and/or musculoskeletal ultrasound may be done prior to the injection to insure a proper diagnosis and rule out any condition best treated surgically.

The PRP injection usually takes an hour and is performed on an outpatient basis. Do not take anti-inflammatories one week before or after the injection as this may limit the treatment benefits.

Depending on a patient’s condition, a series of 1-3 injections may be required.

How do I care of the injection site after the treatment?

Initially the procedure may cause some localised soreness and discomfort. Patients may apply ice and elevation as needed. After one week the patient will likely begin rehabilitation program with physical therapy.

What are the significant side effects?

The risks are usually uncommon.

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  • If you have an mild pain or swelling at the injection site, you may want to rest and keep an ice pack on your knee for 15 to 20 minutes, or as recommended by your doctor.
  • Avoid putting a lot of strain on your knee – such as with jogging, heavy lifting, or prolonged standing – for 48 hours after the injection, or as recommended by your doctor.

How will I know When it is Time for Another Treatment with SYNVISC or Synvisc-One?

  • Since there is no known cure for osteoarthritis of the knee, and it is a chronic condition that does not go away, it is important that you continue to see your doctor regularly
  • Track your symptoms, and if you notice pain or stiffness returning, speak with your doctor about scheduling your next appointment
    • Your doctor will decide if and when it’s appropriate to repeat treatment
  • Repeat treatment with SYNVISC and Synvisc-One has been proven to be effective with a favourable safety profile.

Osteoarthritis is a chronic condition, and regular contact with your doctor can help you prevent pain from interrupting your daily activities.

Call (+65) 6471 2674 (24 Hour) to fix an appointment with our specialist to have Synvisc Treatment Today.

Relieves joint pain & improves mobility to put the spring back in your step and choices back into your life!

Synvisc (sodium hyaluronate) is a treatment to provide relief from the pain of osteoarthritis (OA). Now you have an alternative to the use of pain killers such as nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids.

Given by your doctor, this proven treatment reduces joint pain and improves joint mobility allowing you to resume some of the activities you once enjoyed.

Synvisc Benefits: Lubricates, cushions and protects the joint

Synvisc renews more efficient lubrication and cushioning absent from the synovial fluid of an arthritic joint. It helps to restore essential properties of the synovial fluid.

Synvisc helps to lubricate, cushion and protect the joint, bringing relief that lasts up to 6 months, from one simple injection.

Synvisc is a simple procedure

The procedure is called visco-supplementation – a simple procedure done by an orthopaedic surgeon. Your doctor injects Synvisc directly into the joint where it combines with the synovial fluid.

For many patients, relief occurs after a few days and optimum results shortly, thereafter. Unlike other treatments that may require up to five injection, Synvisc only requires a single injection.

Synvisc – Pure and Simple. Helps you get back in the game!

Important benefits of having Synvisc treatment

Patients can look forward to some of Synvisc advantages:

  • Significant pain reduction from osteoarthritis
  • Enhanced joint mobility and joint protection
  • Long term relief achieved with one single injection
  • Resumption of many activities you once enjoyed

Synvisc is made from a natural product

Synvisc is a highly purified, clear fluid made from a natural substance called sodium hyaluronate, which has been used in medicine for over 20 years. Synvisc has been specially formulated for single injection therapy. Your doctor can give you Synvisc by injection directly into the joint to relieve the pain of osteoarthritis at that site.

Synvisc added benefits of local treatment

  • Synvisc avoids the side effects often seen with traditional systemic osteoarthritis treatments
  • Synvisc injected into the joint at that site of discomfort restores the viscocity of the synovial fluid

Discuss Synvisc with your doctor

You and your doctor can decide if Synvisc is right for you. Ask for more information about the benefits of this pure and simple way to relieve osteoarthritis pain and enhance joint function.

Call +65 64712674 to discuss with our orthopaedic surgeon on how Synvisc can help you today.

How the knee joint moves

To understand how this new treatment – Synvisc works, it is important to first understand how the knee joint moves.

Osteoarthritis Knee

The knee joint is formed where the thigh bone, called the femur, meets the shin bone, called the tibia. That joint is covered by the kneecap or patella and is secured by muscle, tendons and ligaments, which allow the knee to bend and straighten.

The surfaces where the two bones touch are covered with a tough substance called cartilage. The space called the synovium inside the knee contains synovial fluid that helps to cushion the weight supported by the knee joint and also lubricates the bones – working like grease on a squeaky hinge.

In osteoarthritis, the synovial fluid loses its ability to lubricate ans cushion the joint effectively. As a result, the cartilage can be destroyed. The unprotected bones then rub together causing pain.

For more information, call +65 64712674 now.