Intra-articular Hyaluronic Acid with Versus without Corticosteroids for Knee Osteoarthritis Among Patients Presenting at Dr. Ziauddin Hospital, Karachi, Pakistan: A Retrospective Cohort Study

Objective: To compare the effectiveness of intra-articular hyaluronic acid injections with and without addedcorticosteroid in patients with knee osteoarthritis.Study Design: Retrospective cohort study.Place and Duration of Study: This study was conducted at the Department of Orthopedic Surgery, Dr. ZiauddinHospital (North Nazimabad Campus) in Karachi, Pakistan from 1st February 2025 to 30th April 2025.Methods: A total of 150 adults (aged 30–70) with symptomatic knee osteoarthritis who received a single intraarticular knee injection were identified: 75 patients received a 6 mL injection of cross-linked sodiumhyaluronate alone, and 75 patients received 6 mL of the same hyaluronic acid combined with 8g triamcinolonehexacetonide. Pain was assessed by the Visual Analog Scale (VAS) at baseline and at 3, 12, and 24 weeks postinjection. Knee symptoms and function were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and 12 weeks. SPSS version 23 was used for data analysis.Results: At 3 weeks, mean VAS pain was 4.35 in the hyaluronic acid and corticosteroid group vs 5.97 in thehyaluronic acid group (P=0.001). This advantage persisted at 12 weeks (P=0.001) and 24 weeks (P=0.001). Bothgroups showed significant improvement from baseline in WOMAC scores at 12 weeks. WOMAC pain decreasedby 0.57 points in hyaluronic acid and corticosteroid vs 0.44 in hyaluronic acid only (P=0.001 for within-groupimprovements), and WOMAC function scores improved by 7.07 vs 5.46 points, respectively (both P=0.001within-group).Conclusion: Hyaluronic acid and corticosteroid co-injection can be a valuable option for more rapid symptomrelief, while hyaluronic acid alone remains beneficial for longer-term management. How to cite this: Shahid S, Munshi N, Siddiqui AM, Azmatullah U, Azizi A, Aziz A. Intra-articular Hyaluronic Acid with Versus without Corticosteroids for Knee Osteoarthritis Among Patients Presenting at Dr. Ziauddin Hospital, Karachi, Pakistan: A Retrospective Cohort Study. Life and Science. 2025; 6(4): 448-454. doi: http://doi.org/10.37185/LnS.1.1.982