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Intra-articular injection of hyaluronic acid for treatment of osteoarthritis knee: comparative study to intra-articular corticosteroids



Osteoarthritis (OA) is a chronic degenerative joint disease characterized by pain and progressive functional limitation. Although both corticosteroid and hyaluronic acid (HA) injections are widely used to palliate the symptoms of knee OA, few researches involving a comparison of two interventions have been conducted.

The objective of the study was to compare the efficacy and safety of HA to corticosteroid injections for the treatment of knee OA.

Patients and methods

We enrolled 60 patients with knee OA who were randomized to receive intra-articular injection of either HA or the corticosteroid. The therapy was followed for 6 months. The patients treated with HA received one course of injections per week for 3 weeks and the other group received single injection of corticosteroid. The two groups were compared as regards pain and functional improvement using the Western Ontario and McMaster University Osteoarthritis Index and visual analog scale.


The study included 60 patients, with age ranging from 36 to 65 years with a mean of 51.8 years. All of them were diagnosed with knee OA using ACR clinical classification criteria. Patients were recruited between May and December 2015.

After 6 months of the treatment, both groups showed functional improvement. HA group showed significant improvement compared with the corticosteroid group as regards the Western Ontario and McMaster University Osteoarthritis Index and visual analog scale (P=0.01).


Both HA and corticosteroid groups showed improvement in pain and knee function, but the intra-articular HA was superior to corticosteroid on long-term follow-up. This supports the potential rate of intra-articular HA as an effective long-term therapeutic option for patients with OA of the knee.


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Correspondence to Mona Hamdy.

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Elsawy, S.A., Hamdy, M. & Ahmed, M.S. Intra-articular injection of hyaluronic acid for treatment of osteoarthritis knee: comparative study to intra-articular corticosteroids. Egypt Rheumatol Rehabil 44, 143–146 (2017).

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