110 patients (117 knees) with knee osteoarthritis were randomized to three weekly intra-articular injections of either hyaluronan (HA) (Hylan G-F 20) or saline. The purpose of this study was to evaluate and compare outcomes of pain and loss of activity between groups. Visual analog scales were used in the evaluation of patients over 26 weeks following the first injection. Results demonstrated significantly lower pain on weight-bearing and at rest in the HA group compared to the control group over the 26 week assessment period. Additionally, loss of activity was significantly lower in the HA versus control group throughout follow-up.