srjcmsSRJCMSSRJCMS2788-885110.47310/srjcms.2025.v05i01.015Effects of Intra-Articular Steroids, Hyaluronic Acid, and Their Combination in Patients with Knee Osteoarthritis: A Systematic ReviewBackground: Knee osteoarthritis (OA) is a leading cause of disability worldwide, necessitating effective symptom management strategies. Intra-articular (IA) injections, including corticosteroids (CS), hyaluronic acid (HA), and their combination, are widely used to alleviate pain and improve joint function. Objective: This systematic review evaluates and compares the efficacy and safety of IA corticosteroids, hyaluronic acid, and their combination therapy in patients with knee OA. Methods: A comprehensive literature search was conducted. Randomized controlled trials, systematic reviews, and meta-analyses assessing pain reduction, functional improvement, and adverse events were included. Results: CS injections demonstrated rapid, short-term pain relief but diminished efficacy over time and potential cartilage loss with repeated use. HA injections provided modest, longer-term symptom relief with a favorable safety profile. Combination therapy leveraging both CS and HA showed superior pain control and functional improvement compared to either agent alone, with comparable safety outcomes. Conclusion: While CS and HA individually offer important therapeutic benefits in knee OA management, their combination appears to enhance both short-term and sustained symptom control. Patient-specific factors and disease severity should guide the selection of IA injection strategies. Further high-quality trials are warranted to optimize treatment protocols.