Durolane is a single-injection hyaluronic acid viscosupplementation product used in the management of knee osteoarthritis pain. Unlike multi-injection viscosupplements, Durolane is formulated as a single-dose treatment, making it an efficient and well-tolerated option for both practitioners and patients. This guide covers everything aesthetic and orthopaedic practitioners need to know about Durolane — from mechanism of action and patient selection through to injection technique, expected outcomes, and clinical considerations when ordering wholesale.

What Is Durolane?

Durolane (manufactured by Bioventus) is a non-animal stabilised hyaluronic acid (NASHA) gel, derived from bacterial fermentation rather than animal sources, which reduces the risk of allergic reaction. It contains 60 mg of hyaluronic acid in a 3 ml prefilled syringe, with a concentration of 20 mg/ml.

Its NASHA technology cross-links hyaluronic acid in a way that significantly extends residence time within the joint space — providing up to 6 months of pain relief from a single injection. This distinguishes Durolane from products such as Synvisc (which requires 3 injections) or Orthovisc (3 injections), offering a more convenient treatment protocol for both the practice and the patient.

Indications for Durolane Injection

Durolane is indicated for the symptomatic treatment of pain in osteoarthritis of the knee in patients who have failed to respond adequately to conservative non-pharmacological therapy and simple analgesics. It is approved for use in adults only.

Key indications include:

  • Mild to moderate knee osteoarthritis (Kellgren-Lawrence Grade I–III)
  • Patients seeking a non-surgical, non-opioid pain management option
  • Patients who have had inadequate response to NSAIDs or physical therapy
  • Patients who wish to delay or avoid total knee replacement
  • Athletes or active individuals requiring pain management without systemic medication

Contraindications

Before administering Durolane, practitioners should screen patients for the following contraindications:

  • Known hypersensitivity to hyaluronic acid or any component of the formulation
  • Active knee joint infection or skin disease at the injection site
  • Venous or lymphatic stasis in the affected leg
  • Active systemic infections
  • Pregnancy or breastfeeding (insufficient safety data)

Caution should also be exercised in patients on anticoagulant therapy due to the risk of intra-articular haematoma.

Durolane Injection Technique

Preparation

Durolane is supplied as a single-use, prefilled syringe of 3 ml. It should be stored at room temperature (below 25°C) and should not be frozen. Allow the product to reach room temperature before injection if stored in a cooler environment.

Required equipment:

  • Durolane 3 ml prefilled syringe
  • 21–23 gauge needle (not supplied)
  • Sterile gloves and draping
  • Antiseptic skin preparation solution
  • Local anaesthetic (optional, for patient comfort)

Injection Approach

Durolane can be administered via several intra-articular approaches. The most common are:

Superolateral approach (most common):

  • Patient lying supine with knee in full extension
  • Insert needle lateral to the superior pole of the patella, directing it medially and slightly downward into the joint space
  • Aspirate to confirm intra-articular placement (absence of blood or synovial fluid reflux is reassuring)
  • Inject the full 3 ml slowly with minimal resistance

Anteromedial or anterolateral approach (for flexed knee):

  • Patient seated with knee at 90°
  • Insert needle at the medial or lateral edge of the patellar tendon into the joint space
  • Preferred in patients with difficulty extending the knee fully

Ultrasound guidance is strongly recommended to confirm accurate intra-articular placement, particularly in obese patients or those with significant joint effusion. Studies consistently show ultrasound-guided injections achieve higher accuracy and better clinical outcomes.

Post-Injection Instructions

Following Durolane administration:

  • Advise patients to avoid strenuous activity, prolonged standing, or heavy lifting for 48 hours
  • Ice application to the knee for 15–20 minutes post-injection may reduce discomfort
  • Mild swelling, warmth, or stiffness at the injection site is expected and typically resolves within 24–72 hours
  • Onset of pain relief typically occurs within 4–8 weeks post-injection

Durolane Dosing and Treatment Schedule

One of Durolane’s key clinical advantages is its single-injection protocol. The standard dosing is:

  • One intra-articular injection of 3 ml (60 mg hyaluronic acid) into the affected knee
  • Effects last up to 6 months in many patients
  • Re-injection can be performed after 6 months if symptoms return, based on clinical assessment

This simplified protocol significantly reduces the treatment burden on both practitioners and patients compared to multi-injection viscosupplementation regimens, improving patient compliance and scheduling efficiency.

Expected Clinical Outcomes

Clinical trial data and real-world evidence support the efficacy of Durolane in reducing pain and improving function in knee osteoarthritis patients:

  • DUROLANE single injection has demonstrated non-inferiority to 3-injection Synvisc in randomised trials
  • Pain relief sustained for up to 26 weeks (6 months) in the majority of responders
  • Significant improvement in WOMAC (Western Ontario and McMaster Universities Arthritis Index) scores
  • Functional improvement in patients with Kellgren-Lawrence Grade II–III OA
  • Well-tolerated safety profile with low incidence of serious adverse events

Patient response varies. Approximately 60–70% of patients report meaningful pain relief. Outcomes tend to be better in patients with mild-to-moderate rather than severe OA, and in patients with a lower BMI.

Durolane vs Other Viscosupplements: A Quick Comparison

Understanding how Durolane compares to other injectables in the viscosupplementation category helps practitioners select the right product for each patient:

  • Durolane vs Synvisc: Synvisc requires 3 injections (1 per week); Durolane achieves comparable results in a single injection. Both are HA-based, but Synvisc uses avian-derived HA, which carries a slightly higher allergy risk.
  • Durolane vs Orthovisc: Orthovisc is a 3- to 4-injection regimen; Durolane’s single-shot protocol is more convenient. Orthovisc is also avian-sourced.
  • Durolane vs Monovisc: Monovisc is the closest comparable product — also a single injection. Both are non-animal sourced. Monovisc is available in a slightly higher concentration (88 mg in 4 ml vs Durolane’s 60 mg in 3 ml).
  • Durolane vs Euflexxa: Euflexxa is a 3-injection protocol; non-animal sourced. Durolane offers the advantage of a single visit.
  • Durolane vs Supartz FX: Supartz FX requires five weekly injections and is avian-derived. Durolane’s single-injection protocol and non-animal origin make it a significantly more convenient and allergy-safe alternative.

Bioresus stocks the full range of viscosupplementation injectables. Browse Durolane wholesale pricing and availability on the product page.

Patient Selection Tips for Durolane

To maximise clinical outcomes and patient satisfaction, consider the following when selecting patients for Durolane:

  • Ideal candidates: Kellgren-Lawrence Grade II–III, BMI under 35, non-response to conservative therapy, active lifestyle requiring pain management without surgery
  • Less ideal candidates: Grade IV OA (bone-on-bone), BMI over 40, significant inflammatory arthritis (RA, psoriatic arthritis), recent intra-articular corticosteroid injection within 3 months
  • Manage expectations: Durolane is not a cure for OA; it provides symptomatic relief. Patients should understand it may take 4–8 weeks to feel the full benefit
  • Document: Take baseline pain scores (VAS or NRS) and functional assessments (WOMAC, KOOS) to objectively track outcomes and support re-treatment decisions

Adverse Events and Safety Profile

Durolane has a well-established safety record. The most commonly reported adverse events are local and transient:

  • Injection site pain (most common)
  • Swelling and effusion (typically resolves within 72 hours)
  • Warmth and redness at the injection site
  • Stiffness post-injection

Serious adverse events are rare but include:

  • Septic arthritis (risk minimised with aseptic technique)
  • Pseudoseptic reaction (acute inflammatory flare, typically resolving spontaneously)
  • Hypersensitivity reactions (very rare with non-animal sourced HA)

Practitioners should advise patients to contact the clinic immediately if they experience increasing pain, significant swelling, fever, or any signs of systemic reaction following injection.

Ordering Durolane Wholesale

Bioresus is a UK-based wholesale supplier of aesthetic and orthopaedic injectables, supplying licensed practitioners across the UK and internationally.

Licensed practitioners can order Durolane at wholesale prices through Bioresus. All products are sourced from authorised distributors and shipped with full cold-chain integrity documentation.

Volume discounts are available for practices ordering regularly. Contact the Bioresus team for pricing and account setup.

Conclusion

Durolane’s single-injection NASHA formulation makes it one of the most practical viscosupplementation options available for knee osteoarthritis management. Its proven efficacy, non-animal origin, and convenient single-dose protocol make it a strong choice for practitioners looking to offer a high-compliance, evidence-based joint injection service.

Whether you are setting up a new orthopaedic injection service or looking to streamline your existing viscosupplementation protocol, Durolane is a product worth having in your formulary. Ensure all patients are thoroughly assessed, counselled on realistic expectations, and followed up to document outcomes and determine candidacy for re-treatment.