Clinical Inquiries: How do hyaluronic acid and corticosteroid injections compare for knee OA relief?

Inconsistent evidence shows a small amount of pain relief early (one week to 3 months) with corticosteroid (CS) injections and an equally small improvement in pain relief and function later (3 to 12 months) with hyaluronic acid (HA) injections (strength of recommendation [SOR]: B, meta-analysis of a randomized controlled trial and inconsistent RCTs). Guidelines state that CS injections can be considered for symptomatic knee osteoarthritis, but that insufficient evidence exists to recommend HA injections (SOR: B, evidence-based guidelines).