Abstract
Background: Osteoarthritis (OA) is the most common degenerative joint disease, with the knee being the most frequently affected site. Although oral glucosamine and chondroitin have shown variable efficacy, intra-articular delivery may enhance local bioavailability and therapeutic response in early OA.

Objective: To evaluate the efficacy and safety of intra-articular glucosamine-chondroitin injections in early knee OA.

Methods: This prospective, randomized, double-blind, placebo-controlled pilot trial included 30 patients with Kellgren–Lawrence grade I–II knee OA. Group A received weekly intra-articular glucosamine sulfate (500 mg) plus chondroitin sulfate (400 mg) for 4 weeks; Group B received placebo. Pain (VAS), function (WOMAC), KOOS subscales, and adverse events were assessed at baseline, 1, 3, and 6 months.

Results: Baseline characteristics were comparable between groups. At 6 months, Group A showed significantly greater reductions in VAS (2.9 vs 5.2; p<0.001) and WOMAC scores (34.2 vs 44.5; p<0.001) compared to placebo. KOOS subscales (pain, ADL, symptoms, QoL) were also significantly improved in the intervention group (p<0.001 for all). No serious adverse events occurred; mild local reactions were self-limiting.

Conclusion: Intra-articular glucosamine-chondroitin injections produced significant and sustained improvements in pain, function, and quality of life in early knee OA with excellent safety. Larger trials with imaging endpoints are warranted to confirm potential disease-modifying effects