In this study of 254 patients with an average age of 66, corticosteroids (CS) demonstrated superior short-term clinical benefits with nearly 45% of patients achieving significant functional improvement, whereas hyaluronic acid (HA) was the only treatment to provide clinically relevant pain and functional relief at the 36-month follow-up. Despite these symptomatic differences, both groups experienced significant radiographic worsening in Kellgren-Lawrence grades and medial joint space narrowing over the study period. Furthermore, the CS group showed unique short-term deterioration in lateral joint space narrowing, though neither treatment ultimately differed in their impact on knee swelling or the total rate of progression to knee arthroplasty.
