Introduction

Knee gel injections, such as hyaluronic acid and Arthrosamid, are becoming increasingly popular as a way to ease the pain of osteoarthritis. For many people suffering from persistent knee discomfort, these treatments offer renewed hope for better mobility and less pain. Yet, a common question remains: will these injections be covered by the NHS or private insurance, and how do the rules differ between the UK and the US? In this article, we'll break down these issues in a practical, straightforward way to help you better understand your options and what to expect financially.

What Are Knee Gel Injections?

Knee gel injections involve injecting a jelly-like substance directly into the knee joint to help relieve symptoms of osteoarthritis. The most familiar type is hyaluronic acid, which acts like a lubricant and shock absorber inside the joint. Another option is Arthrosamid, a synthetic hydrogel designed to provide longer-lasting cushioning and support. Hydrogels like Arthrosamid have actually been used in medicine since the late 1980s, with uses ranging from drug delivery to tissue repair. A recent review found that Arthrosamid “seems to be an efficacious and safe treatment option for knee OA and provides positive results for at least 2 years.” Further research also showed that this treatment was even more effective than hyaluronic acid in certain groups, especially younger patients, those with normal body weight, and those with less severe joint damage. These injections are generally considered when simpler treatments—like painkillers or physiotherapy—haven't provided enough relief.

NHS Coverage for Knee Gel Injections: What You Need to Know

Currently, the NHS usually does not fund hyaluronic acid or other gel injections for knee osteoarthritis because of questions around cost-effectiveness and long-term benefits. Corticosteroid injections, which are steroids to reduce inflammation, are more commonly available through the NHS due to their lower cost and established use. If you are hoping to have knee gel injections through the NHS, your options may be limited to rare cases or clinical trials, meaning most patients have to pay for treatment privately. It’s worth noting that research has demonstrated “numerically superior data” for Arthrosamid compared to hyaluronic acid in some trials, which might encourage future changes in funding. Still, for now, understanding the difference in costs between NHS treatment and private care is crucial if you are considering this option.

Private Insurance Coverage for Knee Gel Injections in the UK

Private health insurance in the UK may cover knee gel injections, but coverage varies widely between insurers. Typically, policies require evidence that you have tried other treatments without success and may limit coverage to certain injection brands. You are likely to need medical documentation and pre-authorisation before you proceed. If you are insured privately, it’s essential to check the details of your policy carefully and maintain open communication with your provider to avoid unexpected bills. Encouragingly, Arthrosamid has been shown to be safe, with studies confirming “no long-lasting adverse events reported” following injection, which could support discussions with your insurer about coverage eligibility.

Understanding Insurance Rules and Patient Strategies in the US

In the United States, insurance coverage for knee gel injections can vary significantly, depending on the plan. Many insurers require pre-authorisation and may insist that patients try other treatments first before approving knee gel injections. It’s important to check your policy details ahead of time and gather all the necessary medical paperwork. If your insurance initially declines coverage, don’t be discouraged—appeals can often be successful, especially when backed by strong medical evidence. The fact that Arthrosamid “provides positive results for at least 2 years” is an important point to include in any appeal. Understanding and navigating these insurance rules carefully can help limit your out-of-pocket costs and give you better access to treatment.

Practical Tips for Patients: Questions to Ask and Cost Management

Taking control of your treatment and insurance journey is key. When discussing knee gel injections with your clinic or insurer, consider asking:

1. Does my policy cover knee gel injections, and are there any conditions or restrictions?
2. What prior treatments or paperwork do I need to provide for approval?
3. How do I begin a pre-authorisation or appeal process if needed?
4. What might my out-of-pocket expenses be if coverage is partial or denied?
5. Where can I find reliable clinical studies or evidence to support my case?

Gathering up-to-date, trustworthy information can strengthen your discussions and appeals. Advances in hydrogel technology have been significant, with “rapid advances in polymer chemistry, crosslinking approaches, and hydrogel fabrication methods” improving the scope and effectiveness of these treatments.

Conclusion

Coverage for knee gel injections differs widely between the NHS, UK private insurance, and US insurance plans. The NHS currently limits funding for these treatments, while private insurers in the UK may offer coverage under certain conditions. In the US, the landscape is varied and often requires persistence and advocacy. By understanding these differences and preparing well, you can navigate your options with greater confidence, manage costs effectively, and pursue meaningful relief from knee osteoarthritis pain.

References

Cole, A., Maulana, R. K., Whitehead, J. P., & Lee, P.Y.F. (2022). A systematic review of the novel compound Arthrosamid polyacrylamide (PAAG) hydrogel for treatment of knee osteoarthritis. Medical Research Archives, 10(8). https://doi.org/10.18103/mra.v10i8.2950
Bliddal, H., Beier, J., Hartkopp, A., Conaghan, P. G., & Henriksen, M. (2023). Polyacrylamide hydrogel versus hyaluronic acid in knee osteoarthritis: A subgroup analysis of a randomized study. Orthopaedic Proceedings, 105-B(SUPP_13), 81. https://doi.org/10.1302/1358-992x.2023.13.081
Clegg, J. R., Adebowale, K., Zhao, Z., & Mitragotri, S. (2024). Hydrogels in the clinic: An update. Bioengineering & Translational Medicine, 9(6). https://doi.org/10.1002/btm2.10680