Gel shot vs standard injection: which quiets arthritic knees?
NCT ID NCT04045431
First seen Sep 16, 2026 · Last updated Sep 17, 2026 · Updated 1 time
Summary
Researchers are comparing two single injections for knee osteoarthritis: an experimental polyacrylamide hydrogel gel and a standard hyaluronic acid shot called Synvisc-One. The trial enrolls about 238 adults aged 40 and older with mild to moderate knee arthritis confirmed by X-ray. Participants receive one injection into the painful knee, and researchers track pain, stiffness, and physical function over six months, with longer follow-up for those who continue.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- polyacrylamide hydrogel injected into the knee joint
- What this could lead to
- If it works, this gel could offer a longer-lasting single injection for knee osteoarthritis pain, possibly delaying the need for surgery.
- What could go wrong
- The gel may not outperform the standard hyaluronic acid injection, and any injected device carries risks of joint swelling, pain, or infection. Results from this mid-stage comparison may not apply to all knee arthritis patients.
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Study facts
What this study's own registry entry says, in plain language.
- Phase
-
Not a phased trial
Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.
- Participants
-
238 people
The number who actually took part.
- Started
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May 2019
- Finished
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Mar 2025
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
-
40 years and older
- Sex
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Anyone
- Healthy volunteers
-
Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Male or female, aged ≥ 40 years * Clinical diagnosis of knee OA American College of Rheumatology criteria confirmed by radiology * Definite radiographic OA in the most symptomatic knee (target knee) at mild to moderate-stage (Kellgren-Lawrence grades 2 or 3) * Stable dose of analgesics for the past four weeks * NRS (11 points (0-10) pain intensity numerical rating scale) ≥ 4 in target knee, during the past week when walking * Body Mass Index (BMI) between 20-35 * For females of reproductive potential: use of adequate contraception must be used throughout the trial Exclusion Criteria: * Female participants who are pregnant, lactating or planning pregnancy during the course of the clinical investigation * Contraindications to PAAG-OA or Synvisc-One®, according to IB or Instruction for Use (IFU) * Previous intra-articular injection of polyacrylamide gel in the target knee * Previous intra-articular injection with hyaluronic acid or derivatives in target knee in the previous 6 months * Significant valgus/varus deformity of the knee, ligamentous laxity or meniscal instability * Other diseases in target knee than osteoarthritis * Intra-articular injection of any substance other than hyaluronic acid (e.g. corticosteroids) in the target knee within the last 3 months * Acute serious infection of any region that required hospital care or intravenous antibiotic treatment within the last 30 days, or oral antibiotic treatment within the last 14 days * Skin disease or infections in the area of the injection site * Infected or severely inflamed knees * History of sepsis in any joint or any clinical concern for a subacute infectious process in the target knee * History of surgery in the target knee within the past 6 months * Symptomatic osteoarthritis of the hips, spine or ankle, that interferes with the evaluation of the target knee * Planned surgery on any lower extremity * Clinically significant venous or lymphatic stasis present in the legs * Clinically apparent tense effusion or inflammation in the target knee * Suffering from any unstable or severe cardio-vascular disease * Any contraindication to intra-articular e.g. anticoagulant therapy or clinical concern for potential coagulopathy (e.g. liver disease) * Any foreign material in the target joint * Any significant medical condition (e.g. significant psychiatric or neurological disorders or active alcohol/drug abuse), any medical condition that is unstable/poorly controlled or other factors that may interfere with study participation * Treatment with systemic steroids * History of drug/alcohol abuse, mental dysfunction of other factors limiting their ability to cooperate fully * Change in physiotherapy within the previous month * Fibromyalgia * Inflammatory or other disease/condition which may affect joints (e.g. rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis among others) * Haemophilia * Any other condition that in the opinion of the investigator put a potential participant at risk or otherwise precludes participation in the trial * Known allergic reactions to components of Synvisc-One (avian protein) * Known allergic reactions to antibiotics (azithromycin and moxifloxacin) or local anaesthesia * Participation in any experimental device study within 6 months prior to enrolment, or participation in an experimental drug study within 1 month prior to enrolment
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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A2 Reumatologi og idrætsmedicin
Hillerød, Denmark
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Reumatolog i Odense
Odense, Denmark
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The Parker Institute
Frederiksberg, Denmark
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