Treating Knee Osteoarthritis with Hyaluronic Acid Injections: A Case Study from McFerran Physio

Introduction
Knee osteoarthritis can be life-limiting for many people — affecting simple activities like walking the dog or climbing stairs. In this case study, we share how McFerran Physio helped a 48-year-old man reduce his pain, restore function, and regain control over his daily life using a combined physiotherapy and hyaluronic acid injection approach.

Patient Background
This 48-year-old man had been suffering from left knee pain for nearly a year. An X-ray ordered by his GP confirmed moderate osteoarthritis, a degenerative joint condition that often worsens with time and impacts mobility.

His main complaints included:

• Pain while walking (especially during longer walks with his dog).
• Discomfort when using stairs.
• Night pain that sometimes woke him when turning in bed.

Despite being active and otherwise healthy, the knee pain had begun to significantly interfere with his quality of life.

Assessment & Diagnosis

At McFerran Physio, we began with a comprehensive subjective and objective assessment, which revealed:

• Reduced range of motion in the left knee:
  • Incomplete extension and limited flexion compared to his non affected side.
  • End-range stiffness and a hard joint “block” — consistent with osteoarthritis.
• Quadriceps atrophy (muscle wasting).
• Decreased strength in both the quads and hamstrings on the affected side.
• Hip and spine ruled out as contributing sources of pain.

The findings aligned with his X-ray report and confirmed that knee osteoarthritis was the primary issue.

Treatment Discussion & Plan

Step 1: Patient Education

We spent time helping the patient understand:

• What osteoarthritis is.
• Why it’s common — particularly with age and joint use.
• That osteoarthritis does not always equal inevitable decline or constant pain.

We explained that joint changes are as normal as grey hair or wrinkles — and that movement, not rest, is key to managing symptoms.

Step 2: Conservative Treatments

Following NICE guidelines (National Institute for Health and Care Excellence), we discussed several options:

• Exercise therapy (especially strengthening the muscles around the knee)
• Activity modification
• Pain management (e.g. paracetamol, ibuprofen, topical gels)
• Steroid injections
• Hyaluronic acid injections Hyaluronan Injections | Side-effects, uses, time to work

The patient was reluctant to take regular medication or pursue steroid injections due to concerns about potential side effects and joint damage. However, he was very interested in learning more about hyaluronic acid injections as an alternative.

Hyaluronic Acid Explained

We explained the science behind hyaluronic acid (HA):

• A natural component of synovial fluid — the fluid that lubricates joints.
• HA helps cushion, protect, and nourish joint surfaces.
• In osteoarthritis, synovial fluid becomes thinner and less effective.
• HA injections, like Ostenil Plus, aim to restore joint lubrication, reduce inflammation, and relieve pain.

There is strong evidence showing that HA injections can provide longer-lasting pain relief than steroid injections for some patients.

Hyaluronic Acid injections Therapy Bristol for Pain & Inflammation Relief | McFerran Physio

Combination Treatment Approach

We agreed on a dual strategy:

1. Start a progressive strengthening program for the quads and hamstrings.
2. Administer a hyaluronic acid injection to relieve pain and enable better compliance with exercise.

At his next visit, we confirmed:

• No current infections.
• No allergy or history of anaphylaxis.
• Patient consent was obtained.

The HA injection was performed safely with no side effects.

Patient Outcome

Immediate Results

• One week post-injection:
  • Completely pain-free.
  • Back to walking his dog without needing to stop and rest.
  • Fully engaged in his exercise programme.

Follow-Up Results

• 6 months later: Patient contacted us for a second HA injection due to excellent results from the first.
• 3 months after second injection: No recurrence of pain and no further contact — indicating continued relief.

Conclusion

This case highlights the effectiveness of combined conservative physiotherapy and hyaluronic acid injection for managing moderate knee osteoarthritis.

At McFerran Physio:

• We offer in-house hyaluronic acid injections.
• We follow evidence-based guidelines.
• We support shared decision-making to find the best solution for each patient.

If you’re struggling with knee pain from osteoarthritis and want to avoid surgery, we can help.

Book a consultation today to discuss your treatment options.