What Is Monovisc? Uses, Dosage, and What You Need to Know in 2026

If you or someone you know is dealing with knee osteoarthritis and hasn't gotten adequate relief from physical therapy, anti-inflammatory medications, or other conservative treatments, your doctor may have mentioned Monovisc. This guide explains exactly what Monovisc is, what it treats, how it's given, and whether it might be right for you.

What Is Monovisc?

Monovisc is a single-injection viscosupplement — a medical treatment designed to supplement the natural lubricating fluid in the knee joint. It contains high molecular weight, cross-linked sodium hyaluronate (a form of hyaluronic acid) derived from bacterial fermentation, suspended in a phosphate-buffered saline solution.

Monovisc is manufactured by Anika Therapeutics, Inc. in Bedford, Massachusetts, and distributed in the U.S. by DePuy Synthes (a Johnson & Johnson company). It was FDA-approved in 2014 as a Class III medical device (PMA P090031) — notable because unlike most medications, Monovisc is regulated as a device, not a drug.

What Is Monovisc Used For?

In the United States, Monovisc is FDA-approved for one specific indication:

Treatment of pain caused by osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics (e.g., acetaminophen).

This means Monovisc is not a first-line treatment. It's intended for patients who have already tried and not gotten adequate relief from approaches like:

Physical therapy and exercise programs

Weight management

Acetaminophen (Tylenol)

Oral or topical NSAIDs (ibuprofen, naproxen, diclofenac)

Bracing or orthotics

Outside the U.S. (in EU countries and Canada), Monovisc has broader approval covering osteoarthritis pain in the shoulder, hip, knee, and ankle joints — making it a more versatile treatment internationally.

Who Is Monovisc For?

Monovisc is approved for adults 21 years of age and older. Ideal candidates typically:

Have a confirmed diagnosis of knee OA (usually supported by X-ray imaging)

Have tried conservative treatments for at least 3 months without adequate pain relief

Are not candidates for or want to delay knee replacement surgery

Have no active knee infection, severe intra-articular effusion, or bleeding disorders that would contraindicate an injection

Monovisc Dosage and How It's Given

Monovisc is administered as a single 4 mL intra-articular injection directly into the knee joint space by a trained healthcare provider. Each pre-filled syringe contains:

Volume: 4 mL per syringe

Total HA dose: 88 mg sodium hyaluronate (the maximum single-injection HA dose currently available in the U.S.)

Concentration: 22 mg/mL

Molecular weight: 1–2.9 million Daltons (high molecular weight)

HA source: Bacterial fermentation (Streptococcus equi) — non-avian

The injection is performed under sterile conditions. An 18–20 gauge needle is used, and any synovial fluid or effusion in the knee is removed before injecting Monovisc using a separate syringe. The entire procedure takes only a few minutes.

How Long Does Monovisc Last?

Clinical trial data demonstrates that Monovisc may provide pain relief lasting up to 6 months (26 weeks) in many patients. In the pivotal clinical trial, patients treated with Monovisc showed statistically significant improvements in WOMAC Pain Score compared to saline control at weeks 7–22, with meaningful improvements in function and quality of life.

Pain relief typically doesn't kick in immediately after the injection. Most patients begin noticing improvement 2–4 weeks post-injection, with maximum benefit often achieved by 4–8 weeks. Individual response varies — some patients experience dramatic relief, while others see modest or no improvement.

Is There a Generic Monovisc?

No. As of 2026, there is no FDA-approved generic equivalent to Monovisc available in the United States. Monovisc is a brand-only specialty product, which is part of why the cash price ($1,521–$2,047 per syringe) remains high. Other HA viscosupplements like Euflexxa and Orthovisc are made by different manufacturers with different formulations and are considered separate products, not generics.

To learn more about how Monovisc works at a molecular level, see our article on Monovisc's mechanism of action. Ready to find a provider? medfinder can help you find who has it in stock near you.