Data from 7 RCTs, investigating 955 intra-articular hyaluronic acid (IAHA) injection patients and 495 control patients, was pooled to evaluate the safety and efficacy of IAHA in the treatment of Kashin-Beck disease (KBD). The evidence presented in this meta-analysis indicated that the overall effectiveness of IAHA and control was 93.7% and 62.9% respectively. IAHA patients demonstrated very large treatment effects compared to pre-treatment values over 12 months. IAHA also demonstrated significantly superior results after 1 month up to 12 months compared to controls. HA, CD44, KS, IL-1Beta, TNF-Alpha, and NO, were all significantly improved compared to healthy controls in non KBD areas.