A non-steroid hyaluronic acid injection for arthritic joints.
Ostenil® Plus is a single-injection viscosupplementation treatment containing hyaluronic acid with mannitol. Hyaluronic acid is a natural part of healthy joint fluid, and in osteoarthritis the aim of the injection is to support joint lubrication and ease pain in suitable patients. Where Durolane sits specifically within the knee joint as a longer-acting single shot, Ostenil Plus is a versatile option also considered for shoulder, hip, thumb-base and other osteoarthritic joints after careful assessment — often preferred by patients who would rather discuss a non-steroid route first.
Who considers it
When osteoarthritis is making ordinary movement harder.
Osteoarthritis can quietly make ordinary movement feel harder than it should. Stiffness, swelling and joint pain can affect walking, stairs, sleep, work and exercise. Many patients we see have already tried weight management, exercise, pain relief or physiotherapy before they ask about injections.
If you have knee osteoarthritis or another suitable arthritic joint, the consultation starts by understanding what is driving your pain. We look at your history, examination, previous treatments, activity goals and any imaging already available before suggesting Ostenil Plus or another route.
Walking
Stairs
Sleep
Work
Exercise
How it works
Supporting the joint's own lubrication system.
Cartilage
Joint fluid
Hyaluronic acid
Added hyaluronic acid
Mannitol
Painful, stiff movement
01
A healthy joint
In healthy joint fluid, hyaluronic acid helps the cartilage surfaces glide smoothly.
Illustration of the principle, not patient dataSimplified schematic, not to scale.
Hyaluronic acid is found naturally in joint fluid, where it helps the surfaces glide smoothly. In osteoarthritis, the joint environment changes and movement can become painful or stiff. An Ostenil Plus injection introduces additional hyaluronic acid directly into the joint, supporting lubrication and cushioning in selected patients.
The mannitol component is included to help protect the hyaluronic acid from oxidative breakdown, which may support its duration of effect. Response and how long the benefit lasts vary between patients.
We use ultrasound guidance where appropriate so the clinician can see the joint during the procedure and support accurate placement. Your consultation explains how Ostenil Plus compares with steroid injection, Arthrosamid, PRF, physiotherapy and onward referral so you can choose with a clear head.
Joints we commonly treat
Where Ostenil Plus is commonly considered.
Ostenil Plus is more versatile than knee-only hyaluronic acid preparations and is considered across the major synovial joints affected by osteoarthritis. Suitability is decided at consultation after a full musculoskeletal assessment.
Choose a joint
Choose a joint on the figure, or from the list above.
Suitability for any joint is decided at consultation.
The Ostenil Plus advantage
Lubrication support, symptom reduction and non-steroid care.
For the right diagnosis, hyaluronic acid offers a different approach to joint pain — working with the joint's natural chemistry rather than suppressing inflammation alone.
01
Supports joint lubrication
Ostenil Plus contains hyaluronic acid, a natural part of joint fluid. The aim is to support lubrication in a suitable osteoarthritis-affected joint.
02
May ease pain and stiffness
Some patients notice less pain or stiffness after hyaluronic acid injection. Response and duration vary, and suitability is checked before treatment.
03
Non-steroid option
Ostenil Plus may suit patients who want to discuss a non-steroid injection option for osteoarthritis-related symptoms. Risks and alternatives are covered in consultation.
Pain · Rehabilitation · Function
A quieter knee is the start. A stronger one is the goal.
We treat the injection as one part of a wider plan rather than the whole answer. For knee osteoarthritis, that plan is built around strength, walking and the stairs you want to manage again.
01Ease
Settle the pain
By supporting lubrication and cushioning inside an arthritic knee, Ostenil Plus can ease pain and stiffness for some patients, so moving stops feeling like a risk.
02Rebuild
Make rehab possible
With a quieter knee, the exercises that protect it become easier to start: strengthening the thigh muscles, practising sit-to-stand and building a regular walking routine.
03Return
Improve function
Stronger muscles help support the joint. That is what makes stairs, longer walks, gardening and getting up from a chair easier over the following weeks.
What knee rehab usually involves
01
Thigh strengtheningSimple quadriceps exercises, like the seated knee straightening in the photo, build the muscle that supports the knee.
02
Sit-to-standRising from a chair, slowly and repeatedly, trains exactly the movement that daily life asks for.
03
A walking programmeShort, regular walks that lengthen gradually, rather than one long walk that flares the knee.
04
Stairs, step by stepLow step-ups, progressed as strength and confidence return.
Responses vary, and not everyone needs an injection. Exercise remains the foundation of osteoarthritis care; a physiotherapist can tailor and progress the plan.
Mild to moderatethe stage of osteoarthritis for which Ostenil Plus is most suitable
A few weeksbefore those who respond typically notice improvement
Six to twelve monthsthe region in which benefit commonly lasts, in those who respond
Not permanentosteoarthritis is progressive, but the injection can be safely repeated when symptoms gradually return
So how well does it work, and for how long? Ostenil® Plus is most suitable for mild to moderate osteoarthritis and is a popular choice for people who remain active or who want to delay a joint replacement. Across clinical use, more than 90% of patients have rated the success of hyaluronic acid treatment as very good(1). In practice, those who respond typically notice improvement within a few weeks, with benefit commonly lasting in the region of six to twelve months. The effect is not permanent — osteoarthritis is a progressive condition — but the injection can be safely repeated when symptoms gradually return. Side effects are uncommon and usually limited to mild, short-lived soreness at the injection site.
TRB Chemedica. Ostenil hyaluronic acid injection for osteoarthritis. trbchemedica.ch
Individual results vary. Suitability for any treatment is assessed during your consultation.
How the joint injections compare
Not interchangeable. Each has its moment.
The three injection routes we most often discuss for arthritic joint pain are not interchangeable — each suits a different point in the journey. Your consultation tailors the recommendation to your diagnosis, previous treatment and goals.
How Ostenil Plus, Durolane and Arthrosamid differ for knee osteoarthritis. You are reading about Ostenil Plus.
The knee familyThree single-injection routes for knee osteoarthritis
You’re hereOstenil PlusHyaluronic acid with mannitol
Hyaluronic acid with mannitol, given as a single injection
Non-animal stabilised hyaluronic acid (NASHA): a more cross-linked formulation, given as a single injection
A polyacrylamide hydrogel: 97.5% water and 2.5% cross-linked polyacrylamide, given as a single injection
How it is thought to help
Supports joint lubrication and cushioning, working with rather than suppressing inflammation
Works mechanically, restoring some of the cushioning and lubrication lost in osteoarthritis
Becomes integrated with the soft tissues of the joint lining, with the aim of long-term symptom relief
Staying power
Mannitol helps protect the hyaluronic acid from oxidative breakdown
Resists breakdown: a slower-clearing gel than standard linear hyaluronic acid
Non-biodegradable: the body does not metabolise or clear it
Joints
Knee, shoulder, hip, ankle and base of thumb
Knee (hip and ankle in selected cases)
Knee
Most often considered for
Mild-to-moderate osteoarthritis where joint preservation and a non-steroid route are priorities
Knee osteoarthritis when a longer-acting single treatment is the priority
Moderate-to-severe knee osteoarthritis without adequate relief from conservative options
Benefit, as reported
Several months in suitable patients; individual response varies
Several months from one injection in suitable patients
Long-lasting in suitable responders; sustained benefit over several years in selected patients
Knee price
£280Anterior hip £600
£350
£2,400
All three follow a GP-led assessment and are given with ultrasound guidance where appropriate; fees include consultation, the procedure and aftercare. Individual response and duration of benefit vary between patients. This table is a guide, not a substitute for clinical assessment. Compare all joint injections →
A non-biodegradable polyacrylamide hydrogel that integrates with the inner lining of the knee joint capsule.
Advanced knee osteoarthritis where conservative options and shorter-acting injections have been exhausted.
Long-lasting in suitable responders; clinical follow-up has shown sustained benefit over several years in selected patients.
Individual response and duration of benefit vary between patients. This table is a guide, not a substitute for clinical assessment.
Your visit
Assessment, treatment and aftercare, clearly explained.
We know it can feel difficult to book a procedure when you are not sure what will happen next. Your clinician will explain suitability, risks, recovery and aftercare before treatment goes ahead.
First
Book
Choose a consultation online or speak to the clinic if you are not sure which service fits. Most appointments are available within seven days.
Then
Assess
An in-person review with Dr Mugerwa: he will listen to your story and examine the area, which may include an ultrasound scan. You then get an honest recommendation — if treatment is suitable we explain the options, risks and likely outcomes; if it is not, we will tell you and refer you on.
Finally
Treat
The procedure itself, followed by tailored aftercare guidance and a clear contact route if anything changes during recovery.
From a patient
★★★★★
Can't have this injection on the NHS so I'm so happy I can receive it at the Clinic. Easy to get an appointment, excellent facilities, professional and caring doctor. I highly recommend.
The questions patients most often ask about Ostenil Plus — including how it compares with steroid injection and Durolane, what to expect from a single shot, and whether it's right for your particular joint.
How quickly will I feel relief, and how long does it last?
Response and duration of benefit vary between patients. Many people report easier movement and reduced stiffness over the first two to three weeks, with peak benefit commonly described around week six. A single Ostenil Plus injection often provides several months of symptom relief in suitable patients, depending on factors such as the severity of osteoarthritis, daily activity and individual response.
Is Ostenil Plus a steroid?
No. Ostenil Plus is a hyaluronic acid (with mannitol) viscosupplementation. Hyaluronic acid is a natural component of healthy joint fluid, and the injection is intended to support joint lubrication rather than suppress inflammation in the way a steroid does. For some patients — particularly those who would rather avoid corticosteroids — this is the preferred route.
How is Ostenil Plus different from Durolane?
Both are single-injection hyaluronic acid treatments, but they are formulated differently and used in different situations. Ostenil Plus is the more versatile option we use across the knee, shoulder, hip, thumb-base and other osteoarthritic joints. Durolane is a more cross-linked formulation we consider specifically for knee osteoarthritis where a longer-acting single shot is the priority. Your consultation explains which is the better fit for your particular joint and pattern of pain.
What does the mannitol component do?
Mannitol is included as an antioxidant. Its role is to help protect the hyaluronic acid from oxidative breakdown inside the joint, which has been associated in published studies with a longer duration of effect compared with standard hyaluronic acid preparations. It is not a separate active drug — its purpose is to help the hyaluronic acid last longer in the joint space.
Can I have Ostenil Plus if I have diabetes?
Yes — Ostenil Plus does not affect blood glucose, which is one of the reasons patients with diabetes often prefer a hyaluronic acid route over a steroid injection. We still complete a full clinical assessment to confirm suitability before treatment.
Are there any side effects?
Side effects are uncommon and usually mild. The most frequently reported are a short-lived sensation of fullness, mild ache or stiffness in the joint for 24–48 hours after the injection as the gel settles. As with any injection, there is a small risk of bruising or infection at the site, which we discuss with you before treatment.
Will I still need physiotherapy?
We treat the injection as one part of a wider plan rather than the whole answer. For most patients with osteoarthritis, ongoing physiotherapy, exercise, weight management and activity adjustment remain important to maintain joint function. Ostenil Plus often creates the window of relief that makes engaging properly with these easier.
What percentage of people respond to Ostenil Plus?
In cohort studies, around 70 to 80 percent of suitable patients reported a meaningful improvement in pain and function at six months(1). These figures come from observational research rather than large randomised trials, and individual response is assessed at consultation.
