This study investigates whether intra-articular polyacrylamide hydrogel (iPAAG) provides superior outcomes compared to conventional injections, namely hyaluronic acid (HA) and corticosteroid, in managing knee osteoarthritis (KOA). This retrospective cohort study included primary KOA patients (Kellgren–Lawrence grade II–IV) treated between January 2023 and December 2024 with 1 of 3 intra-articular injections: iPAAG (6 mL Arthrosamid), HA (2 mL, 60 mg Artroaid), and Steroid (40 mg methylprednisolone acetate, Arhropan). Outcomes were assessed at baseline, 3, 6, and 12 months. Primary outcomes were the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index. Clinically meaningful improvements were evaluated using minimal clinically important difference (MCID) and patient acceptable symptom state thresholds. A total of 150 patients (n = 50 per group) were included. The groups were comparable at baseline in median age (HA: 66; Steroid: 69.5; iPAAG: 69.5; P = .104), sex (female: 72%, 62%, 66%; P = .566), median body mass index (30.4, 30.6, 30.7 kg/m 2 ; P = .716), and Kellgren–Lawrence distribution ( P = .765). Baseline median VAS was 7, dropping to 3 in all groups at 3 months ( P .05). iPAAG offers comparable short-term efficacy and modest advantage at 6 months. However, long-term superiority is limited. It may be a complementary option in individualized osteoarthritis management. Further prospective studies are needed to define its optimal use.
Aykaç et al. (2025) studied this question.