Is hyaluronic acid more effective than corticosteroids for the treatment of osteoarthritis (OA) of the knee?

EVIDENCE-BASED ANSWER Perhaps. There is no difference between intra-articular hyaluronic acid (IAHA) and intra-articular steroids (IAS) for reducing pain from knee OA 1 to 4 weeks postinjection. At later postinjection time points (5–13 weeks and 13–26 weeks), IAHA has a 15% higher response rate than IAS and is modestly more effective than IAS in improving function, with inconsistent effects on pain. There appear to be no significant differences in adverse events between IAS and IAHA (SOR: B, 2 meta-analyses with divergent results).