The Role of Hyaluronic Acid in Healing Injuries

Quick Summary

Hyaluronic acid is best known as a knee injection for osteoarthritis, but emerging research is exploring its broader role in tissue healing. Studies are investigating whether HA, combined with the body's own anti-inflammatory cells, can improve healing and reduce damage in tendon, cartilage, and soft-tissue injuries. While clinical use beyond intra-articular knee injection remains investigational, the underlying biology supports HA's role in modulating inflammation and supporting repair.

Cartilage repair: the role of hyaluronic acid in healing injuries

In our clinic, we often use a series of injections of hyaluronic acid to treat knee pain due to early to moderate arthritis.

Many patients are already aware of the benefits of hyaluronic acid use topically, as it is now in most facial creams. Indeed, dermatologists have used a form of hyaluronic acid to fill wrinkles for many years.

We know hyaluronic acid has many benefits, as it serves as a joint lubricant and can decrease inflammation. We also know that with surgery, the natural hyaluronic acid is washed away and can take weeks to months to reach normal levels.

This study is interesting as it shows that a new drug in development may be able to turn our body’s own cells into anti-inflammatory cells combined with hyaluronic acid, which improves healing and limits damage.

Stay tuned. We don’t have good interventions (injection or oral therapy) that can stop or reverse arthritis, but for now, we can be comfortable using hyaluronic acid for more than just patients with arthritis. We recently decided to start offering hyaluronic acid injections as a supplement to patients after surgery; while insurance does not cover this type of treatment, it may pay off in the long run.

Read the full article: Revolutionizing cartilage repair: The role of macrophages and hyaluronic acid in healing injuries

Image source NYU Tandon School of Engineering, adjusted for this post.

Frequently Asked Questions

What does hyaluronic acid actually do in the knee?

Hyaluronic acid is a natural component of synovial fluid that lubricates the joint and provides shock absorption. In osteoarthritic knees, native HA breaks down and loses viscoelasticity. Injecting HA can restore viscosity, modulate inflammation, and stimulate the body's own HA production. Effects build over weeks and typically last 4–6 months in patients who respond.

How does HA differ from cortisone for knee pain?

Cortisone is a strong anti-inflammatory with rapid onset (days) but shorter duration (4–8 weeks). Hyaluronic acid works more slowly (over weeks) but lasts longer (4–6 months) and avoids cortisone's side effects on cartilage and blood sugar. I generally use cortisone for acute flares and HA for sustained osteoarthritis pain — and sometimes combine them based on the clinical picture.

Is HA used for tendon or ligament injuries?

HA injection for tendon and ligament injuries remains largely investigational. Some studies show promise for tendinopathy and adhesive capsulitis, but the evidence is mixed and use is mostly off-label. For most tendon injuries I rely on structured loading rehabilitation as the primary treatment, considering injections only when loading work hasn't produced enough improvement.

Related Reading

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Dr. Sabrina Strickland sees patients at Hospital for Special Surgery in New York City. If you would like a personalized evaluation of your symptoms and options, request a consultation below.

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Medical Disclaimer. This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult with a qualified physician regarding any questions about your orthopedic health. Individual results may vary based on diagnosis, anatomy, and overall health.
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