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Ostenil® Plus injections in Tunbridge Wells: one injection for joint arthritis
Ostenil® Plus tops up the slippery fluid inside an arthritic joint with a single injection. At Vale it’s placed under ultrasound guidance, after a free consultation to check it suits your joint.
A healthy joint is bathed in synovial fluid. Much of its thickness comes from hyaluronic acid, which lets the joint surfaces glide and soaks up some of the load when you walk or climb stairs.
In osteoarthritis the cartilage thins and this fluid becomes thinner and less elastic. The joint can feel stiff in the morning, ache after activity and grind or click as it moves.
Exercise, weight management and painkillers are the starting point. When they aren’t enough, an injection of hyaluronic acid is one way to try to restore some of that lubrication.
Ostenil® Plus is a sterile gel of sodium hyaluronate, the form of hyaluronic acid used in joint injections. Each pre-filled syringe holds 40 mg in 2 ml, made by fermentation rather than from animal tissue.
It also contains mannitol, a sugar alcohol. Mannitol mops up free radicals, unstable molecules made in an inflamed joint, which would otherwise break hyaluronic acid down faster.
Standard Ostenil® is usually given as a course of weekly injections. Ostenil® Plus has a higher dose, so one injection is normally enough for a treatment.
What it won’t do: Ostenil® Plus doesn’t rebuild cartilage or reverse arthritis. Its aim is to ease pain and stiffness for a period of months.
What it may offer
Possible benefits
Based on research into hyaluronic acid injections in general. Some people notice a clear change; others notice little.
One visit
A single injection, so you don’t need to come back each week for a course.
Less pain
Trials of hyaluronic acid show pain scores often fall over the following weeks.
Easier movement
Less stiffness can make walking, stairs and getting up from a chair easier.
No operation
No anaesthetic, no cut and no recovery period. You walk out afterwards.
Is this right for you?Find out if Ostenil® Plus suits your joint at a free consultation.
The injected gel adds to the hyaluronic acid already in the joint fluid. That is thought to improve lubrication and shock absorption for a time.
Laboratory studies also suggest hyaluronic acid can damp down inflammation in the joint lining. That may be why relief can outlast the gel itself, which the body clears within weeks.
01
Lubrication
The gel thickens the joint fluid so the surfaces slide more easily.
02
Cushioning
Thicker fluid absorbs more of the force when you put weight through the joint.
03
Protection
Mannitol slows the breakdown of the hyaluronic acid inside an inflamed joint.
Who it suits
Who may benefit from Ostenil® Plus?
Ostenil® Plus is mainly used for mild to moderate osteoarthritis of the knee. It can also be used in the hip and other larger joints.
It tends to suit people whose pain limits walking, sleep or exercise, and who have already tried exercise and painkillers. It may also suit people who would rather avoid repeated steroid injections.
It’s less likely to help when arthritis is very advanced and the joint space has largely gone. In that case we’ll talk honestly about other options, including Arthrosamid® or a surgical opinion.
The evidence
What does the research show?
The research on hyaluronic acid injections is mixed, and we think you should know that before you decide.
A Cochrane review of 76 trials found that hyaluronic acid improved knee pain and function compared with placebo. The clearest effect was between about 5 and 13 weeks [1].
A later analysis of the largest, best-run trials found the benefit was small [2].
NICE advises the NHS not to offer hyaluronic acid injections for osteoarthritis [3].
So the average benefit across large groups is modest. Within that average, some people improve clearly and others not at all. We can’t predict which group you’ll be in, but we can tell you whether your joint looks like a reasonable candidate.
Compared
How does Ostenil® Plus compare?
Ostenil® Plus
Durolane
Cingal®
Cortisone
What it is
Hyaluronic acid with mannitol
Stabilised hyaluronic acid
Hyaluronic acid with a steroid
Steroid
Injections
One
One
One
One
Relief starts
Over 2–4 weeks
Over 2–4 weeks
Within days
Within days
Price at Vale
£300
£350
£400
£250
Steroids act quickly but tend to wear off sooner. Hyaluronic acid works more slowly. Cingal® combines the two in one syringe, and Durolane is a longer-lasting form of hyaluronic acid.
“In his own words
David on his Ostenil® injections
David Thompson describes his knee, his treatment and how things have been since.
This is his personal experience. Everyone responds differently.
We ask about your symptoms, your general health, your medicines and what you’ve tried so far. We examine the joint and scan it with ultrasound, and look at any X-rays or MRI scans you have.
02
Step 2 of 4
Deciding together
We explain whether Ostenil® Plus is a sensible choice, what else you could try and what each option costs. There’s no pressure to go ahead on the day.
03
Step 3 of 4
The injection
The skin is cleaned and the needle is guided into the joint using the live ultrasound picture. If there’s a lot of fluid in the knee, we may draw some off first. The injection itself takes a few minutes.
04
Step 4 of 4
Aftercare
You can walk out and drive home. Take things easier for a day or two, avoiding running, long walks and heavy lifting, then build up gradually with the exercises we give you.
Step 1 of 4
When to get help
After your injection
Mild soreness for a day or two is common. Contact us, or seek urgent medical advice, if the joint becomes increasingly hot, red, swollen and painful, or you feel feverish or unwell. These can be signs of infection, which is rare but needs prompt treatment.
Injection Therapist and Chiropractor, Clinic Director
GCC 03996
Dr Gabriel Azzini
Doctor, Sport & Exercise Medicine
GMC 7689922
Registered and regulated
Google reviews
What our patients say
5.0from 150 Google reviews
Hyaluronic acid★★★★★
I first saw Gary for a consultation regarding the arthritis in my knees with a view to having a hyaluronic acid injection. Gary was extremely knowledgeable and went through all the options before suggesting which would be the best option for me.
Paula F. · 2025 · Google review
Knee injection★★★★★
My mum had acute knee pain which has been treated at the clinic, she now has much better mobility and positive outlook due to the treatment received. Gary has been so helpful and supportive throughout the consultation and treatment.
Robert C. · 2024 · Google review
Cortisone injection★★★★★
I recently had an ultrasound guided cortisone injection with Gary… Gary took the time to explain everything clearly before the procedure which really put me at ease, not easy when you’re not a fan of needles! The process itself was essentially pain free.
James T. · 2026 · Google review
Frozen shoulder★★★★★
Gary helped me with my frozen shoulder. He was very thorough, professional and informative. I was given a cortisone injection, which he talked me through. During the procedure he was calming and efficient.
Annette P. · 2026 · Google review
Stem cell★★★★★
I cannot thank Gary and Gabriel enough for the stem cell treatment they gave me. When I started my treatment my tendonitis was so bad in my elbows that I couldn’t carry my little children, drive the car or do my day job without getting in severe pain.
Most people describe a sharp scratch and a feeling of pressure as the gel goes in. Ultrasound lets us place the needle first time, which keeps it quick.
Are there any risks or side effects?
The joint may be sore, warm or slightly swollen for a day or two. Infection is rare but serious, so we use a sterile technique and tell you what to look out for. We’ll go through your health and medicines at your consultation.
How soon will I notice a difference?
Not straight away. Any improvement usually builds over two to four weeks, rather than in the first few days.
How long does it last?
It varies. Some people notice benefit for around six months, some for less, and some notice no change. We review how you got on before suggesting a repeat.
Can I have Ostenil® Plus in my hip?
Sometimes. Ostenil® Plus can be used in the hip and other larger joints, and we use ultrasound to guide the needle into the hip joint. We’ll advise at your consultation.
Can I have it on the NHS?
Usually not. NICE, which advises the NHS in England, doesn’t recommend hyaluronic acid injections for osteoarthritis, so they’re mainly available privately.
Got another question?Ask us at your consultation. You don’t have to go ahead.
ClinicVale Health Clinic, 31–33 Vale Road, Tunbridge Wells TN1 1BS
References
Bellamy N, Campbell J, Robinson V, et al. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006;(2):CD005321. doi:10.1002/14651858.CD005321.pub2
Rutjes AW, Jüni P, da Costa BR, et al. Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis. Ann Intern Med 2012;157(3):180–191. doi:10.7326/0003-4819-157-3-201208070-00473
National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226. 2022.
Written by Gary Edwards, Injection Therapist (PG Cert Injection Therapy) and Chiropractor (GCC 03996). Last updated 15 October 2026.
