162 patients with Kashin-Beck disease (KBD) were randomized to evaluate the efficacy and tolerability of hyaluronic acid (HA) and meloxicam for the treatment of KBD related knee pain. Patients were assigned to either a 3-week course of HA or a 12-week course of meloxicam. When assessed over a 12 week period, both treatments demonstrated significant improvements in pain. The onset of action of in the meloxicam group was quicker showing greater improvement at 1 week, but HA therapy resulted in a more gradual improvement that provided prolonged symptom relief. Additionally, HA appeared to be more tolerable but both treatments were efficacious and well suited for patients with KBD.