The Archives of Physical Medicine and Rehabilitation published a review paper, concluding that hyaluronic acid injections are beneficial for pain management of ankle arthritis. The material is typically derived from a rooster comb & mimics our own natural joint fluid. At the Orthohealing Center in Los Angeles, we typically add the HA along with Platelet Rich Plasma or Bone Marrow Concentrate to form a scaffold/matrix and have a potentially synergistic effect. HA is commonly injected into painful knee arthritis with positive results when the arthritis is less advanced in more active individuals. More & more non-surgical options are needed to address the growing numbers of patients with joint pain. Interestingly, the cartilage in the ankle has a thicker sponge like quality (proteoglycan layer) which may explain why ankle cartilage tends to respond better than knee cartilage to treatment. The new study found that the volume of HA injected as well as the concentration makes a difference in the outcome.