63 patients with bilateral knee osteoarthritis (OA) were randomized to receive either intra-articular hyaluronic acid (HA) or intra-articular triamcinolone hexacetonide (TA) in the most symptomatic knee. The less symptomatic knee in all patients received intra-articular injection of placebo. Findings from the intention-to-treat analysis did not identify any significant differences in efficacy between the two treatments when assessed for 6 months after treatment. Per-protocol analysis demonstrated significantly lower pain in the HA versus TA-treated knee, though was limited by the high loss to follow-up. Neither active treatment (HA or TA) demonstrated significant difference versus placebo-treated contralateral knees.