Effectiveness of Intra-Articular Corticosteroids Versus Hyaluronic Acid for the Treatment of Knee Joint Disease

Background: Knee joint disease, particularly osteoarthritis, imposes a significant burden on musculoskeletal health worldwide. Intra-articular corticosteroid (ICS) injections and hyaluronic acid (HA) injections are two widely practiced therapeutic modalities offering symptomatic relief. However, their comparative effectiveness in terms of pain reduction, functional improvement, and sustained benefit remains a subject of ongoing clinical debate. Objectives: To compare the effectiveness of intra-articular corticosteroids and hyaluronic acid in reducing pain and improving functional outcomes in patients with knee joint disease. Methods: This was a comparative clinical study conducted at Bangladesh Medical University (BMU), Dhaka, from January 2023 to December 2024. A total of 100 patients were enrolled and divided equally into two groups: Group A (n=50) received intra-articular corticosteroid injections and Group B (n=50) received intra-articular hyaluronic acid injections. Pain was assessed using the Visual Analogue Scale (VAS) and functional status using the WOMAC index at baseline, 4, 8, 12, and 24 weeks. Results: At 4 weeks, Group A showed significantly greater pain reduction (VAS: 4.3 ± 1.2 vs. 5.6 ± 1.4; p<0.001). However, at 12 and 24 weeks, Group B demonstrated superior outcomes in pain relief (VAS: 3.4 ± 1.0 vs. 5.8 ± 1.5; p<0.001), functional improvement (WOMAC physical function: 28.4 ± 5.3 vs. 35.2 ± 6.1; p<0.001), and patient satisfaction (highly satisfied: 52.0% vs. 32.0%). Adverse events were mild and transient in both groups. Conclusion: While intra-articular corticosteroids provide rapid short-term relief, hyaluronic acid demonstrates superior and more sustained efficacy in pain control and functional restoration over 24 weeks in patients with knee joint disease. HA is recommended for long-term management of knee osteoarthritis.