Monovisc Side Effects: What to Expect and When to Call Your Doctor

Before receiving a Monovisc injection, it's natural to want to know: what will I feel afterward? Are the side effects serious? How long will they last? This guide gives you a clear, honest picture of what Monovisc side effects look like — from the expected and mild to the rare and serious — so you can feel confident going into your treatment and know exactly when to contact your doctor.

How Common Are Monovisc Side Effects?

Monovisc is generally well-tolerated. In Anika Therapeutics' clinical trials (PMA P090031), the most common adverse events were localized, mild to moderate, and temporary. Serious adverse events were rare. The product has a strong post-marketing safety record across thousands of injections. That said, any intra-articular injection carries some risk of local reactions, and patients should know what to watch for.

Common Side Effects (Expected and Usually Mild)

These side effects are common and typically resolve on their own within 1–3 days:

Joint pain: Mild to moderate pain at or around the injection site is very common immediately after the injection and for 1–3 days afterward. This is a normal response to the introduction of fluid into the joint space.

Joint swelling: The knee may appear slightly more swollen than usual for a day or two following the injection. This is a normal inflammatory response.

Warmth or heat at the injection site: Localized warmth around the knee is common in the first 24–48 hours and typically resolves quickly.

Temporary stiffness: Some patients notice brief stiffness in the injected knee, particularly in the morning, for a day or two after the injection.

Redness or bruising: Light redness at the needle entry site or minor bruising is normal and resolves within days.

Less Common Side Effects

These side effects are less frequent but have been reported in clinical trials and post-marketing experience:

Rash or itching (not always at the injection site)

Headache

Dizziness or lightheadedness

Chills

Nausea

Muscle cramps

Peripheral edema (mild fluid retention, typically in the ankle or lower leg)

Malaise or general fatigue

Serious Side Effects — When to Seek Immediate Medical Attention

While rare, serious side effects can occur and require prompt medical attention. Contact your doctor or go to an emergency room immediately if you experience:

Signs of allergic reaction: Hives, difficulty breathing, swelling of the face, lips, tongue, or throat. Seek emergency care immediately.

Signs of infection: Fever, chills, increasing warmth and redness around the knee, or discharge from the injection site. Joint infections (septic arthritis) are rare but serious and require immediate treatment.

Severe joint pain or swelling that worsens: Pain and swelling that significantly worsens beyond 3 days post-injection — rather than improving — should be evaluated by your provider.

Numbness or tingling: Persistent numbness or tingling around the injection site or in the lower leg may indicate nerve involvement and should be evaluated.

Who Should Not Receive Monovisc?

Monovisc is contraindicated in the following patients — make sure to discuss your full medical history with your provider before your injection:

Known allergy to hyaluronate preparations or gram-positive bacterial proteins (Monovisc's HA is derived from Streptococcus equi)

Bleeding disorders such as hemophilia, or current anticoagulant use that significantly increases bleeding risk

Active infection in or around the knee joint or in the skin overlying the injection site

Age 21 years or younger (Monovisc is not FDA-approved for pediatric or young adult patients)

Post-Injection Care to Minimize Side Effects

Following these guidelines for the first 48 hours after your Monovisc injection can help minimize discomfort:

Avoid jogging, running, tennis, cycling, and other high-impact activities for at least 48 hours

Avoid standing or weight-bearing for more than 1 hour at a time for 48 hours post-injection

Apply ice to the knee for 10–15 minutes if swelling or pain is uncomfortable

Keep the injection site clean and dry for the remainder of the day

For more on Monovisc, see our guides on what Monovisc is and how it works and Monovisc drug interactions.