Abstract
Introduction
Intra-articular (IA) injections of corticosteroids and hyaluronic acid (HA) products are used to treat patients with knee osteoarthritis pain that has not responded to more conservative treatment. Corticosteroids are a standard of care despite only suggestive clinical evidence of 12 or more weeks of pain relief. However the duration of pain relief with this treatment appears to be short and not a long term solution.
Methods
A double-blinded, randomised, active controlled, multicentre non-inferiority trial with 442 subjects provided a pragmatic comparison of HA to methylprednisolone. These patients were collected prospectively and with excellent long term follow-up.
Results
The HA responder rates were good at 12 weeks and better at the later time points (6 to 9 months) while the methylprednisolone rate decreased significantly by 26 weeks.
Conclusion
HA appears to be a reasonable mid to long term solution for patients with Kellgren grade 1 and 2 arthritis. It lasts longer than steroids and has what appears to be a cost-effective advantage.
