Four randomized controlled trials (RCTs) including 390 patients with early-stage knee osteoarthritis (KL I-II) were included in this systematic review and meta-analysis comparing intra-articular hyaluronic acid (HA) injections with other biologically active injections such as platelet-rich plasma (PRP) and corticosteroids (CSs). Pooled outcomes of interest included the visual analogue scale (VAS), the Western Ontario McMaster Osteo-Arthritis Index (WOMAC), and its subscales (pain, stiffness, and function). At the final follow-up (mean: 7.5 months), no significant differences were found between HA and other biologically active compounds in any measured outcomes. These findings suggest that HA injections perform similarly to other common intra-articular treatments in managing early-stage knee OA symptoms over a short-term period.