Efficacy of Intraarticular Hyaluronic acid and Cortico- Steroid Co-Injection versus Hyaluronic acid in Knee Osteoarthritis

Introduction: For knee osteoarthritis, intra-articular injections of Hyaluronic acid and corticosteroid have individually shown promise, nevertheless, the rate at which symptoms improve is a limiting factor for both treatments. Aims and Objectives: To compare mean pain score in patients receiving combination of intra-articular Hyaluronic acid and corticosteroid versus Hyaluronic acid alone in osteoarthritic knee. Place and Duration of Study: The randomized controlled trial was conducted in the Orthopedic Department of Shaikh Zayed Hospital, Lahore, from June 11, 2021, to December 11, 2021. Materials and Methods: The study comprised a total of 64 patients fulfilling the inclusion criteria and after providing informed written consent with 32 patients each assigned to the Hyaluronic acid plus corticosteroid group (Group A) and Hyaluronic acid alone group (Group B). Lottery method was used to randomly divide patients into two groups. Pain was assessed at baseline and at 3 months via visual analog scale. All the data was recorded on preset performa and analyzed via SPSS version 20. Results: Out of 64 patients enrolled in study, 15.6% were male and 34.4% were females in HA+CS group and 12.5% were male and 37.5% were females in HA alone group. Distribution of knee side, 9.4% patients had right while 40.6% had left side in HA + CS group and 23.4% had right while 26.6% had left side in HA alone group. Mean age of HA + CS group was 59.22±8.027 years and mean age of HA alone group was 57.34±6.378 years. Mean pain score was 01 in HA+CS group versus 4.13 in HA group (p<0.001). Conclusion: In current study, we concluded that those individuals who underwent HA and CS co-treatment experienced reduction in mean pain score more as compared to those who received HA alone.