25 patients with a total of 38 knees with osteoarthritis were randomized to the order in which they received either hydrocortisone tert-butylacetate, hydrocortisone acetate, or placebo injections. For each treatment, four injections were given, every 2 weeks. A washout period of 8 weeks was used between injection courses, with patients assessed for pain, tenderness, knee range of motion deficit, timed walking of 75 yards, and complications every 2 weeks during this period. The only significant difference observed was a higher percentage of patients reporting pain improvement following hydrocortisone tert-butylacetate versus placebo at 2-week follow-up; differences at subsequent follow-up time points were not significant. Additionally, all other between-group differences were non-significant for all other outcome measures.