Inclusion Criteria:  Symptomatic Primary knee osteoarthritis (Kellgren-Lawrence stage 2 or 3) Failed other conservative treatment Comply with protocol  Exclusion Criteria:  Allergy to any of the medications in this protocol (Betamethasone, Triamcinolone, Paracetamol, Tramadol) Previous fracture or surgical procedure Previous intra-articular injection in the past 6 months Previous oral Symptomatic slow-acting drugs for osteoarthritis (SYSADOA) (Glucosamine, Diacerein) used in the past 6 months Current infection in the affected limb Uncontrolled Diabetes Mellitus Primary or secondary adrenal insufficiency Coagulopathy or current anticoagulant used Current steroid used Lower extremity weakness