Intra-articular Hyaluronic Acid with Versus without Corticosteroids for Knee Osteoarthritis Among Patients Presenting at Dr. Ziauddin Hospital, Karachi, Pakistan: A Retrospective Cohort Study
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".