Both steroid and hyaluronic acid (HA) shots are commonly used to treat the pain of knee osteoarthritis (OA). Each has been well tested. But few studies have compared the two directly.
This study tested these shots in 50 patients with painful knee OA. One group got a single steroid injection in the painful knee joint, with the possibility of having one more if needed. (About half of the group received a second injection.) The other group got three HA shots over three weeks.
The patients' pain and knee function were measured using three different scales before treatment and again three and six months after treatment. Overall, pain and function scores improved modestly in both groups. However, women showed much less improvement than men for both types of injections. Women's poor outcomes didn't seem to be related to age or to more severe OA. The authors recommend further research to help understand this result, which could have major consequences for how doctors treat knee OA in women.
The authors found the results of the HA unimpressive, especially considering that it was 100 times more expensive than the steroid. The steroid group got similar results with fewer shots, which means they had less pain and less risk of infection. The authors recommend that steroid shots should be the first-line injection to treat the pain of knee OA.
Seth S. Leopold, MD, et al. Corticosteroid Compared with Hyaluronic Acid Injections for the Treatment of Osteoarthritis of the Knee: A Prospective, Randomized Trial. In The Journal of Bone and Joint Surgery. July 2003. Vol. 85-A. No. 7. Pp. 1197-1203.'