251 patients with symptomatic knee osteoarthritis, who did not respond to conservative or pharmaceutical treatment, were randomized to receive either hyaluronate, 20 mL saline (distention) or 2 mL saline placebo as an intra-articular injection. The purpose of this study was to compare changes in pain and function of the affected knee between the treatment groups. Results indicated that over a 26 week period there were no significant differences between the hyaluronic acid group and the placebo group, with the exception of extension ability and global assessments by the physician.