Jared Rubin, Alexander Tham, Michael Allen, James J Butler, Samuel R Montgomery, Nathaniel P Mercer, Bradley A Lezak, Jay Zaifman, John G Kennedy
BackgroundHyaluronic acid (HA) has emerged as a potential biologic adjunct in the management of various foot and ankle pathologies due to its viscoelastic, anti-inflammatory, and chondroprotective properties.MethodsA scoping review of the currently available literature evaluating HA use in foot and ankle pathology was performed, with emphasis on osteoarthritis (OA), osteochondral lesions of the talus (OLTs), and soft tissue disorders.ResultsCurrent evidence suggests that HA injections may provide pain relief and functional improvement across multiple foot and ankle conditions. The most consistent evidence supports potential HA use in soft tissue disorders, including Achilles tendinopathy, plantar fasciitis, and acute lateral ankle injuries. HA may be used as an adjunct in OLT and selected OA applications, although outcomes remain heterogeneous across studies.ConclusionAlthough HA demonstrates a favorable safety profile and potential clinical benefit in selected foot and ankle conditions, currently available evidence remains limited by heterogeneous study designs, inconsistent treatment protocols, and short-term follow-up. Additional high-quality, comparative, and long-term studies are warranted to better define the role of HA in foot and ankle pathology.Level of Evidence:Level V, Scoping Review.