Clinical outcomes of hyaluronic acid-sorbitol injection in athletes with patellofemoral pain: Evaluation of the potential influence of body mass index

Patellofemoral pain (PFP) is a frequent cause of activity-related knee pain and functional limitation in athletic populations. Elevated body mass index (BMI) may contribute to patellofemoral joint loading, but evidence on hyaluronic acid-sorbitol injection outcomes in athletes with elevated BMI remains limited.

To describe longitudinal changes in knee function and symptoms over 6 months after intra-articular hyaluronic acid-sorbitol injection in athletes with PFP, and to explore whether baseline BMI was associated with post-injection improvement.

This prospective, single-arm, non-randomized interventional study included 60 athletes aged 30-55 years who received a single 4 mL intra-articular hyaluronic acid-sorbitol injection. IKDC and KOOS scores were assessed at baseline, 15 days, 3 months, and 6 months. Longitudinal changes were evaluated using linear mixed models, with generalized estimating equations as a sensitivity analysis; exploratory regression and subgroup analyses assessed the association between BMI and improvement.