Post-Durolane Injection Knee Soreness and Stiffness
Mild to moderate soreness and stiffness after Durolane injection is a common, self-limited adverse event that typically resolves within days to 2 weeks and is not concerning unless accompanied by severe pain, fever, or signs of infection.
Expected Post-Injection Reactions
Local pain and swelling after hyaluronic acid injections are the most common adverse events, occurring in approximately 10-13% of patients, and are characteristically mild and self-limited. 1, 2
- Treatment-related adverse events with Durolane occur in 13.1% of patients, with local reactions being the predominant complaint 2
- These reactions are limited to local pain and swelling lasting for a few days in the vast majority of cases 3, 4
- Severe allergic reactions are extremely rare 4
Timeline for Symptom Resolution
Your current symptoms should resolve within 2-14 days, but you should understand that Durolane has a delayed onset of therapeutic action compared to corticosteroid injections. 5
- Significant improvement in pain and function typically begins at 2 weeks post-injection 5
- Maximum therapeutic benefit occurs between 6-26 weeks after injection 1, 5, 2
- The effects of Durolane are delayed but more sustained compared to glucocorticoids 5
Warning Signs Requiring Immediate Evaluation
You should seek immediate medical attention if you develop any of the following:
- Severe, worsening pain that is disproportionate to the expected post-injection discomfort 6
- Fever, chills, or systemic symptoms suggesting infection 6
- Marked warmth, redness, or progressive swelling of the knee 6
- Inability to bear weight on the affected leg
Management of Current Symptoms
For your current soreness and stiffness, use acetaminophen up to 3g daily in divided doses for pain control, apply ice to the affected knee, and avoid strenuous activity for the first few days. 7
- Oral NSAIDs can be used if not contraindicated 7
- Topical NSAIDs provide an alternative with fewer systemic side effects 7
- Gentle range of motion exercises can be resumed as tolerated after the initial inflammatory response subsides 7
Important Context About Durolane Efficacy
You should be aware that recent high-quality guidelines have questioned the routine use of hyaluronic acid for knee osteoarthritis, with the number needed to treat being 17 patients (meaning 16 patients receive no benefit for every 1 patient who does). 7
- The American Academy of Orthopaedic Surgeons and American College of Rheumatology conditionally recommend against routine use of hyaluronic acid due to inconsistent evidence and minimal clinical benefit 7
- When limited to trials with low risk of bias, meta-analyses show that hyaluronic acid's effect size compared to saline injections approaches zero 7
- If you experience inadequate response after the expected 2-6 week onset period, transition to intra-articular corticosteroid injections, which have stronger evidence for short-term pain relief 7