Ultrasound-guided hyaluronic acid injection for ankle osteoarthritis and osteochondral lesions of the talus: A retrospective clinical series.

BACKGROUND

Evidence supporting hyaluronic acid (HA) injections for ankle osteoarthritis (OA) and osteochondral lesions of the talus (OLT) remains limited.

PURPOSE: To evaluate pain relief and clinically relevant outcomes following ultrasound-guided intra-articular HA injection.

METHODS

A retrospective study included 44 ankles treated with ultrasound-guided HA injection between 2020 and 2023. Pain was assessed using the visual analogue scale (VAS) at baseline, 3 and 6 months. Secondary outcomes included minimal clinically important difference (MCID) responder rates and Kaplan-Meier analysis of time free from additional interventions.

RESULTS

Mean VAS improved from 7.95 ± 1.12 at baseline to 5.52 ± 2.27 at 3 months and 6.68 ± 2.03 at 6 months (p < 0.05). MCID responder rates were 65.9% and 36.4% at 3 and 6 months, respectively. Nineteen ankles (43.2%) underwent an additional intervention. Median time free from repeat HA injection or surgery was 24 months.

CONCLUSION

Ultrasound-guided HA injection provided meaningful short-term pain relief and delayed further intervention in a substantial proportion of patients, supporting its role as a bridge treatment for ankle OA and OLT.