Evidence That Hyaluronic Acid (Including Ostenil®) Can Delay the Need for Joint Replacement Surgery

Large U.S. health-claims data show hyaluronic acid injections significantly delay total knee replacement. Non-users had surgery at 0.7 years, those with one course at 1.4 years, and five or more courses delayed surgery by 3.6 years.

Source: PLOS ONE study (Altman et al., 2015).

A 2024 Korean national database study reported that hyaluronic acid users delayed total knee arthroplasty by about one year and had a 39% lower risk of needing surgery. More cycles led to further delay.

Source: BMC Musculoskeletal Disorders (Park et al., 2024).

A summary of published studies notes viscosupplementation with hyaluronic acid as an option for delaying joint replacement, especially in younger patients.

Source: Boston Sports & Biologics blog summarizing research.

A 2025 umbrella review confirmed hyaluronic acid improves pain and function in early to moderate osteoarthritis, supporting its role in slowing progression toward surgery.

Source: MDPI umbrella review (Glinkowski & Tomaszewski, 2025).

Conclusion: Evidence strongly supports hyaluronic acid injections as a class—in which Ostenil® is included—delaying the need for knee replacement, especially with repeated treatment cycles.