The Effect of Hyaluronic Acid Injection on TNF-Alpha and IL-1β in Knee Osteoarthritis

Inclusion Criteria: * Diagnosis of knee osteoarthritis according to ACR (American College of Rheumatology) criteria * Knee pain for more than 3 months * Presence of knee pain resistant to conservative treatment for at least 3 months * To be between the ages of 45-75 * Kellgren-Lawrence stage 2-3 gonarthrosis detected in the available knee direct radiographs of the patients Exclusion Criteria: * Patients with KL stage 1 and 4 OA * Systematic diseases (severe cardiovascular disease, severe renal failure, severe hepatic failure, uncontrolled diabetes, cancer, immunosuppression, haematological diseases, systemic bone diseases) * Bleeding tendency (acquired or inherited) \[lNR\>2 in a patient on Coumadin\], * Infection (systemic or local) * Secondary knee osteoarthritis (inflammatory joint disease, post-traumatic, post-infectious, etc.) * Major knee trauma within the last 1 year * BMI \>40 * History of total knee or hip arthroplasty within 1 year * Pregnancy * History of intra-articular injection within the last 6 months * Patients with Hb less than 11 g/dl and Plt less than 150.000 * Presence of allergy to hyaluronic acid products