Osteoarthritis (OA) is a leading cause of pain and disability worldwide with knee and hip OA projected to affect nearly 1 billion people by 2050. While joint interventions like corticosteroid and hyaluronic acid derivatives are commonly used to manage symptoms, their effectiveness and safety remain uncertain. A systematic review undertaken by Pereira et al 2025 rigorously analyzed large, randomized trials to clarify their effectiveness and safety for managing OA. The findings were as follows: –
Autologous Therapies
Commonly known as PRP (platelet rich plasma), stem cell therapy (adipose mesenchymal stem cells) or autologous conditioned serum, large randomized controlled studies with a lower risk of bias found that the efficacy of autologous therapies for joint OA was not supported.
Corticosteroids
Steroid injections come in the form of betamethasone, methylprednisolone or triamcinolone. The review found that Triamcinolone had the highest effect up to 6 weeks in large randomized controlled trials with lower risk of bias.
Hyaluronic acid
Sometimes used in isolation or combined with diclofenac (anti-inflammatory) or triamcinolone (corticosteroid) , the review found hyaluronic acid to have no effect and in fact increase the risk of adverse events in large randomized controlled trials with lower risk of bias.
Homeopathic products
These included a wide range of substances including atelocollagen (type 1 collagen -animal skin) , capsaicin (capsicum) fasitibant (small molecule drug) sprifermin (human fibroblast growth factor 18), Tr14 (traumeel) /Ze14 (zeel), lorecivivint (potential disease modifying drug), LMFW serum albumin (vertebrate blood albumin), orgotein (anti-inflammatory drug derived form bovine liver), polyacrylamide (water soluble chemical compound). The review found that Tr14/Ze14 showed potential at week 6 in large randomized controlled trials with lower risk of bias.
Conclusion
Some injections can be effective in the management of joint OA. We recommend consultation with medical professionals regarding suitability. Our Shellharbour Health Physiotherapists have the expertise to guide you in this area. Further, OA management is not just about pain relief. At Shellharbour Health our physios aim to optimize physical function and maximize quality of life. Call today for expert guidance in managing your Hip or Knee OA.
CREDIT: Pereira et al, 2025 Osteoarthritis cartilage, 33 (2) p 207-217
