Hyaluronic acid versus corticosteroid in the treatment of knee osteoarthritis

Six ACE Reports were identified from the OrthoEvidence database which compared intra-articular injection(s) of hyaluronic acid to corticosteroid in the treatment of osteoarthritis of the knee. All of the included studies were randomized controlled trials which reported pain and/or functional outcomes within 6 months of intervention. Pooled analysis of pain on a visual analog scale indicated that pain relief was significantly better with hyaluronic acid injections at both 3 and 6 months follow-up; however, this finding was strongly influenced by two studies of lower methodological quality. No significant differences between hyaluronic acid and corticosteroid injections were observed in any functional outcome measurement. Due to incomplete or lack of reporting adverse events, an assessment of safety could not be performed along with this review. Furthermore, these findings only examine short-term differences in the efficacy of these two injection therapies and the effects of each over a longer time period still need to be determined.