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A recent meta-analysis suggested that the efficacy of intra-articular injections of hyaluronic acid for knee osteoarthritis is marginal at best; many patients report improvement, but placebo effects account for much of that improvement (NEJM JW Gen Med Jan 15 2016 and J Bone Joint Surg Am 2015; 97:2047). In this double-blind, randomized trial, 110 patients with painful knee osteoarthritis each received a single injection of either hyaluronic acid (hylan G-F 20; Synvisc) or the corticosteroid triamcinolone acetonide.
Compared with baseline, symptoms improved in both groups through 6 months of follow-up. At 2 weeks, the extent of improvement in pain and function was significantly greater with triamcinolone than with hyaluronic acid, but differ…