An April 2024 study (1) compared intraarticular botulinum toxin type A to corticosteroid and hyaluronic acid. A meta-analysis of data from six randomized control studies and 348 patients was performed.

  • Intraarticular botulinum toxin type A showed similar efficacy with corticosteroid as evidenced by the changes of pain, stiffness  and function based on patient reported outcomes.
  • Intraarticular botulinum toxin type A was shown to be more effective than hyaluronic acid in improving pain.

A March 2023 study (2) reviewed patient data from seven studies and 548 participants to suggest effectiveness and safety of intra-articular botulinum toxin type A injection for knee osteoarthritis. The researchers found that at 4 weeks post-treatment intra-articular botulinum toxin type A injection reduced pain but the effects were not seen at 8 weeks and beyond.

An September 2020 study (3) compared botulinum neurotoxin type A , hyaluronic acid and prolotherapy as a treatment for knee osteoarthritis. In data from 120 patients, researchers showed  botulinum neurotoxin and dextrose prolotherapy were the most, and hyaluronic acid was the least efficient treatments for controlling pain and recovering function in patients.

1 Yang Y, Li G, Su Y. Intraarticular botulinum toxin type A versus corticosteroid or hyaluronic acid for painful knee osteoarthritis: A meta-analysis of head-to-head randomized controlled trials. Toxicon. 2024 Feb 22:107656.
2 Wang C, Zhao J, Gao F, Jia M, Hu L, Gao C. The efficacy and safety of intra-articular botuinum toxin type A injection for knee osteoarthritis: A meta‐analysis of randomized controlled trials. Toxicon. 2023 Mar 1;224:107026.
3 Rezasoltani Z, Azizi S, Najafi S, Sanati E, Dadarkhah A, Abdorrazaghi F. Physical therapy, intra-articular dextrose prolotherapy, botulinum neurotoxin, and hyaluronic acid for knee osteoarthritis: randomized clinical trial. International Journal of Rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue Internationale de Recherches de Readaptation. 2020 Sep 1;43(3):219-27.