No significant short-term advantages of corticosteroids-augmented intra-articular injections of hyaluronic acid for knee osteoarthritis: A meta-analysis

INTRODUCTION: The present meta-analysis investigated whether augmenting hyaluronic acid (HA) with corticosteroids (CCs) is more effective than HA in isolation in patients with knee osteoarthritis (OA). The outcomes of interest were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.

METHODS: This study was conducted according to the 2020 PRISMA statement. In September 2025 the following databases were accessed: PubMed, Web of Science, Google Scholar and Embase. All head-to-head randomized controlled trials (RCTs) comparing intra-articular injections of HA in isolation versus HA augmented with CCs were accessed.

RESULTS: Data from 216 patients were collected and 74% (162 of 216) of the patients were women. The mean patient age was 57.7 ± 4.4 years and the mean body mass index (BMI) was 28.2 ± 3.0 kg/m2. No difference was found in WOMAC scores between 3-4 months of follow-up (P = 0.9); No difference was found in WOMAC scores between 4-6 months of follow-up (P = 0.5).

CONCLUSION: The current level I of evidence suggests that intra-articular HA injections augmented with CCs do not appear to provide clinically relevant advantages in WOMAC outcomes within 3-6 months of follow-up.