Printed From:

Injection Technique

Injection Technique Video

Optimizing Injection Experience With Synvisc-One®

In this demonstration of viscosupplement injection, the superolateral approach is used for the Synvisc-One injection procedure. In addition, this video also demonstrates a recommended technique for determining needle placement and the C.L.A.S.S. method for injecting Synvisc-One.

Remove any synovial fluid or effusion before injecting SYNVISC/Synvisc-One. Strict adherence to aseptic technique must be followed.

C.L.A.S.S. knee injection process

To successfully administer Synvisc-One, remember C.L.A.S.S.

Clean the knee injection location


After marking the location for the injection, apply alcohol, and swab injection site with hyphenate povidone-iodine preparation (e.g. betadine ®).

* Do not concomitantly use disinfectants containing quaternary ammonium salts for skin preparation because hyaluronan can precipitate in their presence.

Apply local anesthesia prior to knee injection

Local anesthesia

Numbing the skin with an ethyl chloride spray or lidocaine injection prior to intra-articular injection may help patients feel more comfortable. If ethyl chloride spray is used, the injection site will need to be cleaned again as per instructions above.

Remove any synovial fluid before knee injection


Insert the appropriate gauge needle (18- to 20-gauge for Synvisc-One; 18- to 22-gauge for SYNVISC); this needle size optimizes fluid dynamics and may help make aspiration and the injection easier. Aspiration confirms accurate needle placement inside the joint space and allows removal of synovial fluid and effusion.

Remove any synovial fluid or effusion before injecting SYNVISC/Synvisc-One. Strict adherence to aseptic technique must be followed.

Inject Synvisc-One® (Hylan G-F 20) into the knee

SYNVISC/Synvisc-One injection

Inject SYNVISC/Synvisc-One using standard techniques; patients should flex and bend the knee 3 to 4 times following injection.

Do not inject SYNVISC/Synvisc-One extra-articularly, into the synovial tissues, into the fat pad or joint capsule, or intravascularly.

Additional post-injection tips for your patients

Set patient expectations and post-procedure education

Tell your patients to:

  • Avoid putting a lot of strain — such as jogging, lifting or prolonged standing — on the knee for 48 hours after the injection treatment or as recommended
  • Care for mild pain or swelling at the injection site by keeping an ice pack on the knee for 10 minutes or as recommended
  • Report any side effects to you or their healthcare team

Make sure to remind them that most patients reported pain relief starting at four weeks after treatment for knee osteoarthritis with Synvisc-One or even as early as 1 week with SYNVISC.

Additional resources for your patients

A number of resources are also available for you to share with your knee OA patients. In addition to English, some are available in Spanish and other languages.

Download Post-Injection Tips ›

Order Synvisc-One® and SYNVISC®

Learn about the different ordering options and how to get next-day delivery with your MySynviscONE® account.

View Options ›


Resources for
Your Patients

Share these tools to help patients get the most out of their treatment.

Resources for your patients
Browse Resources ›