Understanding How Many Times Can Synvisc be Given for Osteoarthritis

October 9, 2025 •

3 min read

Synvisc, a viscosupplement used to treat knee osteoarthritis pain, comes in two distinct formulations with different injection protocols. While the standard course is a specific number of injections, many wonder how many times can Synvisc be given over a patient's lifetime.

Quick Summary

Synvisc injections, and the single-shot Synvisc-One, are approved for repeat use when pain returns, typically no sooner than six months after the last cycle. Your healthcare provider will determine the appropriate frequency based on your condition.

Key Points

Initial Treatment Dosing: The number of injections depends on the specific Synvisc product, with Synvisc requiring three weekly injections and Synvisc-One requiring a single injection.
Repeat Injections Are Possible: Synvisc and Synvisc-One can be repeated when osteoarthritis knee pain returns, typically no sooner than six months after the previous treatment cycle.
No Lifetime Limit: There is generally no set limit to the number of times Synvisc can be repeated, as long as it continues to provide effective pain relief.
Doctor's Discretion: A healthcare provider will determine the need for repeat injections based on a patient's individual response, symptom return, and overall joint condition.
Repeat Safety Profile: Repeat injections are generally safe, with common side effects like swelling and pain at the injection site, which are typically mild and temporary.

Synvisc vs. Synvisc-One: Understanding the Formulations

Synvisc (hylan G-F 20) and Synvisc-One are both forms of a gel-like substance called hylan polymers, which act as a lubricant and shock absorber when injected into the knee joint. However, they differ in their concentration and how they are administered, which is key to understanding how many times they are given.

Synvisc: This formulation requires a series of three separate injections, typically administered one week apart, into the affected knee.
Synvisc-One: This is a higher concentration formula given as a single injection into the knee, offering a more convenient option for some patients.

Initial Treatment Schedules for Synvisc and Synvisc-One

When starting treatment, your doctor will prescribe an initial course based on the product chosen.

For Synvisc: The initial treatment course is a series of three intra-articular injections into the knee, with one week between each injection. It is important to complete all three injections for maximum benefit. Pain relief may not be immediate and can take several weeks to become noticeable.
For Synvisc-One: The initial treatment is a single, one-time injection into the knee. Relief from a single injection can last for up to six months or even longer, but varies between individuals.

Repeating Synvisc Injections Safely

For patients who have responded well to treatment, repeat courses of Synvisc or Synvisc-One are possible and considered safe. The timing of repeat injections is based on the return of symptoms and a doctor's assessment.

When to repeat: A repeat course of injections is typically considered when the pain and symptoms from osteoarthritis return. This can be six months or more after the last treatment cycle. There is no official lifetime maximum for the number of treatment cycles, as long as the treatment continues to be effective for the patient.
Important considerations: Before a repeat injection, your healthcare provider will assess your condition, document the effectiveness of the previous treatment, and ensure the criteria for a subsequent course are met. For example, Medicare and some insurers generally require a minimum of six months between courses of treatment.

Factors Influencing Injection Frequency and Response

Several factors can influence a patient's response to Synvisc injections and the frequency of repeat treatments:

Severity of Osteoarthritis: Patients with more advanced arthritis may find the injections become less effective over time as the joint damage progresses.
Individual Response: The duration of pain relief varies from person to person. Some may experience relief for up to a year, while for others, it may be closer to six months.
Lifestyle: A patient's activity level and weight can affect joint stress and, consequently, the effectiveness and duration of pain relief.

Synvisc vs. Synvisc-One: A Comparison of Injection Protocols


Feature	Synvisc	Synvisc-One
Number of Injections	3 per treatment cycle	1 per treatment cycle
Injection Frequency	One injection per week for three weeks	A single, one-time injection
Volume	2 mL per injection	6 mL per injection
Total Dose	48 mg per treatment cycle	48 mg per treatment cycle
Typical Relief Duration	Up to 6 months, sometimes longer	Up to 6 months, sometimes longer

Risks and Considerations for Repeat Injections

Repeat Synvisc injections are generally safe, but there are potential side effects, which are typically mild and temporary. The most common side effects reported are pain, swelling, heat, and redness at the injection site. Unlike repeat cortisone injections, which can potentially damage joint cartilage with frequent use, hyaluronic acid injections do not have the same risk profile. However, it is essential to discuss any side effects or changes in your condition with your doctor.

Conclusion

While the initial course is a specific number of injections (1 for Synvisc-One, 3 for Synvisc), repeat treatments can be safely administered at the doctor's discretion, typically no sooner than six months after the last course, as long as it remains beneficial. There is no official maximum number of treatments, but the decision to continue is made on a case-by-case basis with a healthcare professional after evaluating the continued effectiveness and considering other treatment options.

For more detailed product information, refer to official sources, such as based on information from SYNVISC-ONE®.

Frequently Asked Questions

You can typically receive a repeat course of Synvisc injections approximately six months or more after your previous treatment cycle, but the exact timing depends on when your symptoms return and your doctor's recommendation.

No, there is no official maximum number of Synvisc injection cycles you can receive over your lifetime. Treatment can be repeated as long as it remains beneficial and safe for the patient, as determined by a healthcare provider.

Synvisc requires a series of three injections, given one week apart, to complete a single treatment cycle. Synvisc-One, on the other hand, is given as a single, one-time injection per treatment cycle.

Relief from Synvisc or Synvisc-One can last for up to six months or even longer, though this varies from patient to patient. Repeat treatment is considered when the pain returns.

Yes, repeat Synvisc injections are generally considered safe. The side effects observed in repeat courses are similar to the initial course, typically being mild, temporary, and localized to the injection site.

Yes, for the standard Synvisc product, it is essential to receive all three injections to achieve the maximum therapeutic benefit.

Yes, it is possible to receive Synvisc treatment in both knees. Your doctor can discuss whether to treat them simultaneously or at different times.

Unlike cortisone shots, which carry a risk of joint damage if overused, viscosupplementation with Synvisc can be repeated without the same risk. Cortisone shots are typically limited to three or four times per year.