Intra-articular treatments for hindfoot osteoarthritis

Abstract

Hindfoot osteoarthritis (HFOA) leads to pain, impaired function, and reduced quality of life. Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis, particularly in young patients with post-traumatic HFOA. Intra-articular injections of corticosteroids and hyaluronic acid are widely used as alternatives for treating foot and ankle osteoarthritis to provide temporary pain relief and functional improvement. Recently, orthobiologic treatments have gained interest for their potential regenerative effects. This review aims to summarize the current evidence on intra-articular injections for HFOA, highlighting the potential benefits, perspectives, and mechanisms of action of conventional and orthobiologic treatments such as platelet-rich plasma, bone marrow aspirate concentrate, and adipose-derived stem cells.

Keywords: Hindfoot; Foot; Ankle; Osteoarthritis; Intra-articular injection; Corticosteroids; Hyaluronic acid; Platelet-rich plasma; Bone marrow aspirate concentrate; Mesenchymal stem cells

Core Tip: Hindfoot osteoarthritis (HFOA), whose prevalence has been increasing over the years, leads to pain, impaired function, and reduced quality of life. Moreover, it becomes symptomatic approximately 15 years earlier than hip and knee osteoarthritis, leading to the need for procedures for long-lasting relief of foot and ankle pain. Intra-articular treatments such as corticosteroids, hyaluronic acid, platelet-rich plasma, bone marrow aspirate concentrate, and adipose-derived stem cells may improve HFOA symptoms.