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Rooster Comb Injections: Cost, Treatment & More

Author

Dr. Stephen Cosentino

PRESIDENT OF EMPIRE MEDICAL TRAINING

Chronic knee pain affects millions of people in the United States. Though this common type of persistent joint pain becomes more common with age, it also affects young adults and teens.

For years, sports medicine physicians have recommended rooster comb injections as an affordable alternative to costly, risky knee surgery. Also known as viscosupplementation, a rooster comb injection is a type of hyaluronic acid injection — so named because it’s derived from rooster plumage — that supplements the synovial fluid lubricating the knees. 

If you’re seeking treatment for knee pain, you’ll encounter providers that offer rooster comb injections soon enough. Find out how to determine if their fees are reasonable — and whether this particular course of treatment makes sense for you.

How Much Do Rooster Comb Injections Cost?

The average cost of a single rooster comb injection was more than $300 in 2016, according to a study published in the New England Journal of Medicine. 

Patients in the study received an average of 3.6 injections per treatment, placing the minimum average cost at about $1,080.

Factors Affecting Rooster Comb Injection Costs

Several factors affect rooster comb injection costs:

  • Wholesale filler pricing. Hyaluronic acid is a type of dermal filler, which means wholesale dermal filler costs set the baseline for rooster comb injection costs. These tend to increase over time.
  • Number of injections per treatment. Because treatments are priced on a per-injection basis, treatments that require more fluid (and thus a greater number of injections) cost more.
  • Location. Retail dermal filler pricing varies by geographic location, driven by local competition and other subfactors.
  • Provider discretion. Ultimately, providers can charge whatever they want. Highly credentialed providers are likely to charge more overall.

For now, Medicare or private insurance typically covers the cost of rooster comb injections, or at least a significant portion of it. But that may soon change for reasons we’ll get into momentarily.

Rooster Comb Injection Costs vs. Knee Replacement Surgery

One thing is for sure: Rooster comb injections cost much less than knee replacement surgery. A typical knee replacement costs anywhere from $15,000 to more than $75,000 all-in. Of course, rooster comb injection results don’t last as long as knee replacements (if they work at all).

Do Rooster Comb Injections Work?

While rooster comb injections may deliver temporary pain relief, controlled studies show limited efficacy for patients with progressive osteoarthritis, according to a STAT review.

The American Academy of Orthopedic Surgeons agrees, even as many of its board-certified members continue to perform rooster comb injections. So while rooster comb injections might be (barely) better than nothing, they may not be worth the cost.

Cost-effective alternatives to rooster comb treatments include physical therapy and anti-inflammatory treatments taken under physician supervision. Both reduce pain while also addressing the root causes of joint pain (which rooster comb injections don’t do very well).

Rooster Comb Injection Side Effects vs. Knee Replacement

One upside of rooster comb injections is that they have fewer complications and side effects than knee replacement surgery. Knee replacements have higher post-surgical infection risk, for example.

Better Uses for Hyaluronic Acid Fillers

One final note: Just because rooster comb injections aren’t very effective doesn’t mean that hyaluronic acid has no benefit for patients. 


On the contrary, medical professionals do recommend hyaluronic acid injections for patients with certain age-related cosmetic complaints, such as nasolabial folds and thinning lips. Just be sure to work with a provider who has completed comprehensive dermal filler training with an accredited medical education institution.