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Arthrosamid®’s story started two decades ago. The brainchild of the team at Contura, the product had been in human use for various indications since 2000, and a favourable safety profile had already been established.

A Clear Comparison of PAAG, Hyaluronic Acid, and Steroids for Treating Knee Osteoarthritis: What You Need to Know

Introduction

Knee osteoarthritis (OA) is a widespread condition that causes pain, stiffness, and difficulty moving for millions of people around the world. Both patients and healthcare providers are constantly searching for effective treatments that relieve symptoms without causing troublesome side effects. Among the many non-surgical options available, three stand out: Polyacrylamide Hydrogel (PAAG), Hyaluronic Acid , and Steroid injections. In this post, we’ll break down how each treatment works, their pros and cons, and what recent research tells us about their safety and effectiveness.

What is Knee Osteoarthritis?

Knee OA occurs when the cartilage cushioning the ends of your bones gradually wears away. This breakdown leads to pain, swelling, and decreased mobility. While it’s most common in older adults, it can develop earlier because of injury or genetics. Non-surgical treatments mainly aim to relieve symptoms and delay the need for surgery, but many only offer temporary relief and can come with potential risks. That’s why finding options that balance effectiveness with safety is so important.

Polyacrylamide Hydrogel (PAAG): How Does It Work?

PAAG is a gel-like substance that’s injected into the knee to enhance the quality of the joint’s natural fluid. This joint fluid acts as both a lubricant and a shock absorber, allowing the knee to move smoothly. By restoring the fluid’s thickness and elasticity, PAAG helps cushion the joint and can reduce inflammation, leading to less pain and easier movement.

Recent studies suggest that PAAG injections can provide symptom relief for several months, and many people tolerate the treatment well. While some may experience mild swelling or rarely, inflammation, complications are generally manageable. Overall, PAAG offers a promising option for those seeking longer-lasting relief from knee OA symptoms.

Hyaluronic Acid and Steroids: What Are the Differences?

Hyaluronic Acid and Steroid injections are well-established treatments for knee OA, but they work in different ways:

  • Hyaluronic Acid is a natural substance found in joint fluid. Injecting it into the knee helps restore the joint’s natural lubrication and cushioning ability. This can ease pain and improve function, usually with few side effects, and the benefits typically last for several weeks or months.
  • Steroids are powerful anti-inflammatory medications. Injected directly into the knee, they quickly reduce pain and swelling by calming the body’s inflammatory response. However, steroid injections offer fast but shorter-term relief and, if used too often, can increase the risk of cartilage damage or other side effects.

In short, steroids are useful for quick pain relief, while hyaluronic acid supports joint health a bit longer with fewer risks.

How Does PAAG Compare?

Research indicates that PAAG offers a nice balance: it provides longer-lasting benefits similar to hyaluronic acid but also helps reduce inflammation like steroids. By improving joint cushioning and reducing inflammation, PAAG can deliver sustained relief, often with less need for repeat injections.

However, the best treatment will depend on the individual’s specific situation—how advanced the osteoarthritis is, any other health conditions, and what treatments have been tried before. While early results for PAAG are encouraging, larger studies are needed to fully understand its long-term role in knee OA management.

Conclusion

PAAG, Hyaluronic Acid, and Steroid injections each play an important role in treating knee osteoarthritis. PAAG, in particular, shows promise as a treatment that offers lasting relief with a good safety profile. As research continues, both patients and healthcare professionals will have more information to help select the best option to improve daily life for those living with knee OA.

References

Gao, H. C. K., Akhtar, M., Creedon, C., Nar, Ö. O., Verma, T., & Lee, P. Y. F. (2025). Polyacrylamide hydrogel injections in knee osteoarthritis: A PROMs-based 24 month cohort study. Journal of Clinical Orthopaedics and Trauma, Article 103136. https://doi.org/10.1016/j.jcot.2025.103136

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