If you have knee osteoarthritis and want to avoid — or delay — surgery, two injections come up again and again: a steroid (cortisone) injection and a hyaluronic-acid injection, often called a “gel” or knee-lubrication injection. They are not the same, and the right choice depends on your knee. This consultant-led guide explains how each works, who each suits, how long they last and what each costs in London.
Written and medically reviewed by Dr James Thing (MBBS, BSc, MRCGP, FFSEM), Consultant in Sport & Exercise Medicine.
A steroid injection calms inflammation and eases pain fast — ideal for a painful flare-up when you need relief quickly. A hyaluronic-acid (gel) injection lubricates and cushions the joint; it usually works more gradually but tends to last longer, which suits ongoing, mechanical arthritis pain. For many people the best plan uses each at the right time. Because the right choice depends on the stage of your arthritis and what your knee actually needs, every treatment here starts with a diagnostic ultrasound and consultation.
A steroid injection delivers a powerful anti-inflammatory directly into the joint under live ultrasound guidance. It is best when pain and swelling are the main problem — for example an arthritis flare-up — because relief tends to come on quickly, often within days. The effect typically lasts from a few weeks to a few months. It is frequently the first injection tried, and it can be a useful way to settle a knee down so you can get moving, exercise and progress your rehab.
A hyaluronic-acid injection (we use Ostenil Plus) tops up the natural lubricating fluid in the joint, helping it move more smoothly and absorb load. It usually works more gradually than steroid but can last longer — around six months or more for many people. It tends to suit knees where stiffness and mechanical, “bone-on-bone” pain are the main issue rather than an acute inflammatory flare.
| Steroid (cortisone) | Hyaluronic acid (gel) | |
|---|---|---|
| Best for | Painful flare-ups; inflammation | Ongoing, mechanical arthritis pain & stiffness |
| How it works | Reduces inflammation | Lubricates & cushions the joint |
| Speed of relief | Fast (often within days) | More gradual |
| Typical duration | Weeks to a few months | Around six months or more |
| Price (all-inclusive) | £525 | £625 |
Both prices are for a consultant-delivered, ultrasound-guided injection. A first appointment with consultation and diagnostic ultrasound is £405. See the full price list.
London pricing varies enormously, and the figure that matters is what is included — is the injection consultant-delivered and ultrasound-guided, and does the price cover the consultation, the scan and follow-up, or are those billed separately? At Joint Care London everything is included: a steroid injection is £525 and a hyaluronic-acid injection is £625, with no hidden extras. For the full picture across every injection type, see our complete guide to injection costs in London.
If steroid and gel injections stop giving you enough relief, you are not out of options before surgery. PRP (platelet-rich plasma) uses your own concentrated platelets to support the joint, and Arthrosamid is a single, long-lasting hydrogel injection developed specifically for knee osteoarthritis. Your consultant will explain where each fits for your knee. For the bigger picture, our blog covers injection options in knee arthritis and a full guide to knee osteoarthritis. If a tendon problem rather than arthritis is driving your pain, you can also compare PRP vs steroid injections.
Your first appointment includes a consultation and a diagnostic ultrasound scan so your consultant can confirm the diagnosis and recommend the right injection. The injection itself takes only a few minutes and most people return to normal activities the same or next day. Typical wait to be seen: 0–1 weeks, compared with 14–21 weeks on the NHS.
Every injection is ultrasound-guided and delivered by Dr James Thing, a Consultant in Sport and Exercise Medicine with over ten years’ experience in musculoskeletal ultrasound. You will be seen within 0–1 weeks at our clinics in Notting Hill, Golders Green and Henley-on-Thames, with transparent, all-inclusive pricing.
Neither is universally better — they do different jobs. Steroid settles a painful, inflamed knee quickly; gel lubricates and cushions and tends to last longer. A diagnostic ultrasound helps your consultant recommend the right one for you.
Steroid typically lasts a few weeks to a few months; hyaluronic acid often lasts around six months or more, though it can take a little longer to work.
Often yes — many people use a steroid injection to settle a flare and a gel injection for longer-term support. Your consultant will plan the timing.
Steroid and hyaluronic-acid injections may be covered by private health insurance; check with your insurer. Either way, we will provide clear all-inclusive pricing.
Not sure which injection is right for your knee? Book a consultation or call 0333 011 1885 — we will confirm the diagnosis on ultrasound and recommend the best option.
