Knee Hyaluronic Acid Injections Market

2020 Analysis and Review Knee Hyaluronic Acid Injections Market by Product Type – Single Injection, Three Injection, Five Injection, and Next-generation (Steroid Combination) for 2020 - 2030


Over the years, the increasing prevalence of osteoarthritis has remained a key challenge among the geriatric population, affecting their quality of life. Although both middle-aged and older people are vulnerable to common pains and inflammations in joints, the impact of osteoarthritis is chronic and has a severe effect on lifestyle among people aged 60 and above.

Osteoarthritis, the most common form of arthritis, affects the cartilage, a tissue that covers the ends of bones in a joint, hardening free movements and causing perpetual pain. Although there is no permanent cure for the disease, a procedure named viscosupplementation has emerged as an effective treatment, recommended by medical professionals when other treatment options fail to relieve the pain.

Viscosupplementation includes the injection of hyaluronic acid, also referred to as hyaluronate, into the knee joint, to improve the lubricating properties of the synovial fluid. Viscosupplementation is not a permanent cure either, but injections from time to time reduce the pain in the knee and aid in improving mobility and comfort. The procedure usually involves three to five injections, each on a weekly basis, and there exists a lucrative revenue opportunity for the knee hyaluronic acid injection market.

As the prevalence of osteoarthritis grows in direct proportion with the ever-widening base of the geriatric population, the demand for viscosupplementation will prevail high, subsequently driving the demand for knee hyaluronic injections for the years to come.

Rising Prevalence of Osteoarthritis Offers Lucrative Opportunity

While aging is considered a crucial cause of osteoarthritis, its incidence has also been attributed to factors such as lack of physical exercise, genetic predisposition, poor bone density, occupational injury, and trauma. Furthermore, obesity and underlying injuries have been identified as major risk factors among young-adults, although the incidence is minuscule in proportion as compared to the older population.

According to the Global Burden of Diseases Study conducted by the World Health Organization (WHO), osteoarthritis is the most common cause of disability in older adults. More than 10% to 15% of adults aged 60 and above develop osteoarthritis of varying intensity, with women being at a higher risk than men.

Currently, over 32 Mn people in the US are living with osteoarthritis, as per the statistics of the Centers for Disease Control and Prevention (CDC). On a global level, over 300 Mn people are currently living with osteoarthritis, and the numbers continue to increase year-on-year.

Similarly, the statistics of the United Nations estimate that people aged above 60 will represent 20% of the global population, among which 20% will suffer from asymptomatic osteoarthritis and 15% will be affected by symptomatic osteoarthritis. These proportions are expected to transmute into 130 Mn of osteoarthritis patients, with 40 Mn poised to suffer severe disability. This is a tremendous opportunity for the knee hyaluronic acid injection market, as the rising number of affected people will continue to seek viscosupplementation treatment, which in turn, necessitates the injection doses.

Proven Efficiency of Hyaluronic Acid Bolsters Adoption

The Osteoarthritis Research Society International (OARSI), recommends both corticosteroids and hyaluronic acid injections for the treatment of osteoarthritis. However, hyaluronic acid injection is preferred over its counterpart owing to its efficiency in pain management. Hyaluronic acid obtained the approval of the US Food and Drug Administration (FDA) in 1997 and has remained a success ever since.

Moreover, several studies have proven the pivotal role played by hyaluronic acid in strengthening bone joints by maintaining the lubrication between them. A review by the National Institute of Health, the US, found that intake of 80 mg to 200 mg daily for at least two months yields positive results among patients.

Present in the form of a gel-like substance, these injections compensate for the shortage of lubricants present between the joints, thus reducing the pain. Although hyaluronic acid is available in the form of a pill, doctors prefer injection owing to its faster response time and more targeted approach.

As the prevalence of osteoarthritis continues to grow year-on-year, with a clinically proven treatment in place, the knee hyaluronic acid injection market will navigate through a remunerative path through the assessment period.

Side Effects: A Major Challenge

While hyaluronic acid injections remain the go-to option for both patients and doctors across the world, certain limitations associated with the treatment are holding back the growth of the market to an extent. Injection-site pain, swelling, heat, redness, rash, itching, bruising around the joint, among others have been reported as the most possible side effects. Although they are temporary, the degree of severity varies from person to person, causing unbearable pain among some.

In some serious cases, fluid accumulation in the injected knee, infections, and bleeding have been identified as complications. Although medical groups have claimed that side effects are due to lack of medical professional's experience and not the treatment's peril, it has negatively influenced the perception of patients towards the treatment.

Along similar lines, the injection treatment provides relief from pain for a period of 3 to 6 months, necessitating another dosage of injections post that. This is pushing patients with higher spending power to opt for knee replacement surgery, which offers a permanent cure to the disease.

On the other hand, a few professional organizations, including the American Academy of Orthopaedic Surgeons, do not recommend hyaluronic acid shots, citing a lack of sufficient concrete scientific evidence proving their effectiveness. Likewise, some studies have found these injections are not more effective than placebo injections, which cost much lower than hyaluronic injections.

By the same token, lack of favorable reimbursement policies, coupled with high expenses-associated with the treatment is also adversely impacting the growth of the market.

Region-wise Analysis

North America Knee Hyaluronic Acid Injections Market

North America is poised to remain at the forefront of the regional landscape, accounting for more than 2/5th of the market value. The region's dominance is primarily attributed to the presence of a wide base of the population suffering from arthritis in the US. According to the estimates of the CDC, one in four US adults are suffering from arthritis and osteoarthritis is its most common form. Moreover, the number is expected to reach 78 Mn in the US alone, creating a wide-scale demand for hyaluronic acid injections in the treatment.

Over 50% of adults with osteoarthritis in the US, representing 18.7 Mn, fall under the working-age group, leading to annual earning losses of US$ 71.3 Bn. Likewise, over US$ 65.5 Bn is spent on medical expenses every year. The exploding numbers call for better treatments and this is expected to drive the market growth. On these lines, the National Public Health Agenda for Osteoarthritis developed by Osteoarthritis Action Alliance (OAAA), Arthritis Foundation (AF), and the CDC released an update in 2020. The updated agenda is focusing on promoting evidence-based, self-management programs, and exploration of advanced diagnosis and treatment options. The aforementioned factors are expected to give a tremendous boost to the knee hyaluronic acid injections market in the region.

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Europe Knee Hyaluronic Acid Injections Market

Closely following North America is Europe, which is poised to account for a share little below one quarter. Akin to North America, the adoption of knee hyaluronic acid injections is associated with the soaring prevalence of the disease in European nations. According to statistics of the British Society for Rheumatology, more than 40 million people across Europe are affected by it, and 45% of the patients have a lifetime risk of knee osteoarthritis. Moreover, osteoarthritis has been identified as the fastest-growing cause of disability worldwide, thus becoming a cause of concern among the region's geriatric population.

On these lines, the European Community and the European League Against Rheumatism took an initiative named EUMUSC with an intention to develop patient-centered and consensus-based standards of care (SOC) for osteoarthritis (OA). Such favorable initiatives will continue to drive the European market on a remunerative growth trajectory.

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East Asia Knee Hyaluronic Acid Injections Market

East Asia is projected to remain the third largest regional market for knee hyaluronic acid injections market, on the back of the growing burden of osteoarthritis in China, Japan, and South Korea. As per recent findings, the number of people suffering from the disease in China grew from 26.6 Mn in 1990 to 61.2 in 2017.

By the same token, a study named Research on Osteoarthritis÷osteoporosis against Disability found that more than 25 Mn people aged above 40 in Japan are suffering osteoarthritis. This bestows a lucrative opportunity to players operating in the knee hyaluronic acid injections market as affected populations continue to seek viscosupplementation treatment methodology.

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Category-wise Insights

Three-injection Highly Sought-after

Three injection viscosupplementation is projected to remain most sought out, accounting for more than half of global value. This is mainly attributed to a high preference among patients due to its proven success and availability of a wide number of approved products across the world. Moreover, single injection viscosupplementation is expected to be second most sought out, backed by its advantages such as limited hospital visits and lower pain or side effects associated with it.

On the other hand, a novel variant named next-generation viscosupplementation is expected to find its niche among patients who are willing to take steroid combinations.

Ambulatory Surgical Centers Drive Majority of Revenue

The ambulatory surgical center segment is projected to account for nearly 1/3rd of the market value by the end of the assessment period. A higher preference for the segment traces back to a shorter duration of stay and lower expenditure as compared to hospitals. By the same note, orthopedic clinics are poised to hold a lucrative share in the market value, ascribed to their affordability, and a growing number of orthopedic centers across the world.

Competitive Landscape

Research & development and new product launches have been identified as the major strategies shaping the competitive landscape of the knee hyaluronic acid injections market. Furthermore, obtaining approvals from the concerning regulatory bodies is a key factor that enables wide-scale deployment which, in turn, ensures, larger growth prospects.

On these lines, Seikagaku Corporation, a Japan-based manufacturer, announced entering an exclusive distributorship agreement in the US with Zimmer Biomet Holdings, Inc. for its knee hyaluronic acid injection named, VISCO-3. The company has other product lines, such as Gel-One® single-injection treatment and SUPARTZ FX, a five-injection treatment that it is distributing across the US.

Likewise, Anika Therapeutics Inc. specializes in a one-injection combination of hyaluronic acid and steroid, named CINGAL, which finds wide adoption in Europe and Canada. As the product is not approved for usage in the US, the organization is now working procuring approval for commercialization in the US.

Knee Hyaluronic Acid Injections Market Report: Scope



Forecast Period


Historical Data Available for


Market Analysis

USD Million for Value and Units for Volume

Key Regions Covered

North America, Europe, East Asia, Latin America, South Asia, Oceania, and Middle East and Africa (MEA)




Key Countries Covered

US, Canada, Brazil, Mexico, Argentina, Rest of Latin America, Germany, Italy, France, Spain, U.K., Russia, BENELUX, Rest of Europe, India, China, Thailand, Indonesia, Malaysia, Japan, South Korea, Rest of South Asia, Rest of East Asia, Australia, New Zealand, GCC Countries, Turkey, South Africa, and Rest of MEA

Key Segments Covered

Product, End Use, and Region

Key Companies Profiled

Seikagaku Corporation (Zimmer Biomet Inc.), Sanofi S. A., Fidia, Farmaceutici S.p.A., Anika Therapeutics Inc. (DePuy Synthes Inc.), Institut, and Biochimique SA (Bioventis LLC) among others.

Report Coverage

Market Forecast, brand share analysis, competition intelligence, DROT analysis, Market Dynamics and Challenges, Strategic Growth Initiatives


Customization & Pricing

Available upon Request

Key Questions Answered by the Report

  • What is the market size of the knee hyaluronic acid injections market?

    The global knee hyaluronic acid injections market is expected to reach a valuation of US$ 2,897 Mn by 2030.

  • Which is the largest regional market for knee hyaluronic acid injections?

    North America currently leads the hyaluronic acid injection knee market and is expected to remain dominant through the course of the forecast period

  • Which are the top companies in the knee hyaluronic acid injections market?

    Key players operating in the market include Seikagaku Corporation (Zimmer Biomet Inc.), Sanofi S. A., Fidia, Farmaceutici S.p.A., Anika Therapeutics Inc. (DePuy Synthes Inc.), Institut, and Biochimique SA (Bioventis LLC) among others.

  • Which end-use segment is expected to channel the majority of revenue to the knee hyaluronic acid injections market?

    The ambulatory surgical centers segment is expected to channel the majority of revenue to the knee hyaluronic acid injections market through the forecast period.

  • What is the outlook on the knee hyaluronic acid injections market?

    The growth of the knee hyaluronic acid injections market is primarily attributed to the increasing prevalence of osteoarthritis.

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  • Is this research conducted by Future Market Insights?

    Yes, the research has been conducted by expert analysts of Future Market Insights through a combination of primary research and secondary research. To know more about how the research was conducted, you can speak to research analyst.

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    FMI follows a methodology that encompasses demand side assessment of the market, and triangulates the same through supply side analysis. This methodology is based on use of standard market structure, methods and definitions.

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Key Segments


  • Single Injection
  • Three Injection
  • Five Injection
  • Next Generation (Steroid Combination)


  • Hospitals
  • Ambulatory Surgical Centers
  • Orthopedic Clinics
  • Retail Pharmacies
  • Online Sales


  • North America
  • Latin America
  • Europe
  • South Asia
  • East Asia
  • Oceania
  • Middle East and Africa

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Knee Hyaluronic Acid Injections Market