Alternatives to Shoulder Replacement

Joint Lubricant Injections for Hip, Shoulder, and Ankle Arthritis

Alternatives to surgery…

Degenerative joint disease, or osteoarthritis, of the hips, shoulders, and ankles causes damage to the joint cartilage, resulting in pain, stiffness, and swelling. Osteoarthritis also causes a loss of synovial fluid, which lubricates the joint and absorbs shock.

Synovial fluid naturally contains an important component called hyaluronic acid. Viscosupplementation is the process of injecting hyaluronic acid into the affected joint to help restore the lubrication lost from degenerative joint disease. Viscosupplementation is more commonly used to treat osteoarthritis of the knee, but has shown promising results in the treatment of hip, shoulder, and ankle osteoarthritis as well, although it is not FDA approved for use in the hips at this time. Therefore, insurance will not cover this procedure.

Procedure and Recovery

Viscosupplementation works best for those who are in the early stages of osteoarthritis. Hyaluronic acid, a thick fluid, is injected into the diseased joint to help replace some of the lubrication lost from arthritis. Ultrasound guidance can help to ensure proper placement of the injection. Improper placement of hyaluronic acid can result in increased swelling and discomfort in the joint, so accuracy is very important.

It is important to remember that viscosupplementation injections will not relieve your hip pain immediately. In fact, it may take several weeks to feel the full effect of the treatment. This treatment also cannot reverse any damage to the cartilage from arthritis, but may help to slow or prevent further damage. Generally, the treatment can be repeated about six months after the injection, if needed.

Benefits of Viscosupplementation

Viscosupplementation may be a good option for those who cannot OR do not want to have surgery, or cannot take NSAID pain medications like ibuprofen, Motrin, or Advil. Clinical studies have shown that hyaluronic acid injections can be as effective as NSAID medications in relieving pain, without the stomach and gastrointestinal risks associated with NSAIDs. Some patients have had more success with viscosupplementation than with steroid injections. Hyaluronic acid may also have anti-inflammatory properties, and could stimulate the body to produce hyaluronic acid on its own, according to some studies.

Other NONSURGICAL SHOULDER Treatments at Wake Sports Medicine


Procedure Covered by insurance
Steroid injection YES
Lubricant (Hyaluronic Acid)-off label NO
PRP (Platelet injection) NO
PRP + Lubricant NO
Prolotherapy NO
Amniotic Stem Cell Injection NO

For more information about alternatives to shoulder replacement offered in Raleigh, NC, call (919) 719-2270 to schedule an appointment with Dr. Kanaan today.


3237 Blue Ridge Rd.

Raleigh, NC 27612

Phone: (919) 719-2270

Mon-Fri: 8 am- 3pm

View Map