Gel injections in the hip are a common non-surgical treatment option for managing pain associated with hip osteoarthritis (OA). Often referred to as a “gel shot,” this procedure involves injecting a specialized fluid directly into the affected joint space. It is typically used when conservative treatments, such as oral medications or physical therapy, have not provided sufficient relief. This treatment is an important consideration for patients seeking to delay or avoid total hip replacement surgery.
Defining Viscosupplementation
The “gel” being injected is hyaluronic acid (HA), and the treatment is scientifically termed viscosupplementation. HA is a molecule naturally found in the body, serving as a major component of the synovial fluid in healthy joints. This natural fluid acts as a lubricant and shock absorber, providing cushion and a low-friction environment for smooth joint movement.
In an osteoarthritic joint, the concentration and quality of natural HA decrease over time. This degradation leads to reduced lubrication and shock absorption, increasing friction between bony surfaces, which causes pain and stiffness. Injecting a synthetic or purified form of HA supplements the natural fluid, aiming to restore the joint environment’s viscosity and elastic properties. This restoration helps reduce pain, decrease inflammation, and improve the hip joint’s overall mechanics and mobility.
The Injection Process for the Hip Joint
Injecting hyaluronic acid into the hip joint differs significantly from injections in superficial joints like the knee. Due to the hip joint’s deep location and proximity to major nerves and blood vessels, the procedure requires specialized image guidance to ensure accuracy and safety. Without this guidance, needle placement may not reliably reach the intended intra-articular space.
The procedure is typically performed using fluoroscopy (live X-ray) or ultrasound technology to visualize the joint in real-time. After positioning the patient and thoroughly cleaning the site, a local anesthetic is applied. The clinician uses the imaging guidance to monitor the needle’s path, carefully directing it into the narrow space of the joint capsule.
Confirmation of proper needle placement is often achieved by injecting a small amount of contrast dye, confirming the needle is within the joint space before the HA is administered. This image-guided approach minimizes the risk of injury to surrounding structures and maximizes the chance of the medication reaching its target. The procedure is generally performed in an outpatient setting and takes only a few minutes to complete.
Candidacy and Expected Results
Candidates for hip viscosupplementation typically have mild to moderate osteoarthritis and have not had adequate relief from first-line treatments (physical therapy, weight loss, or oral pain medications). The treatment is not recommended for those with severe, advanced-stage arthritis where cartilage loss is extensive, as the potential for benefit is much lower.
Relief from the injection is often delayed compared to other joint injections, such as corticosteroids. Patients should expect to wait between two and six weeks before noticing a meaningful reduction in pain and improved mobility. The duration of efficacy is highly variable, but benefits commonly last for several months, often ranging between three and six months.
Viscosupplementation is a palliative treatment intended only to manage symptoms, not a cure for underlying joint degeneration. Evidence suggests that the efficacy of HA injections for hip OA can be less consistent than for knee OA, sometimes showing mixed results compared to a placebo. However, for many patients, the treatment provides satisfactory pain reduction and can delay the need for joint replacement surgery. If the initial injection provides relief, the procedure can often be safely repeated when symptoms return.
Potential Side Effects and Recovery
Following the procedure, patients may experience temporary, localized adverse effects around the injection site. The most common complaints include mild pain, swelling, warmth, or bruising, which are typically short-lived. These symptoms usually resolve within two to four days, and applying ice can help reduce discomfort.
Rarely, more serious complications may occur, such as joint infection, a severe allergic reaction, or bleeding. Patients should contact their healthcare provider immediately if they develop signs of infection, such as a fever, or significantly increased redness, swelling, or heat at the injection site.
Post-injection care involves resting the joint to allow it to settle. Patients are typically advised to avoid strenuous activities or high-impact exercise for at least 24 to 48 hours following the procedure.