2026-10-12T17:01:21Z
https://api.figshare.com/v2/oai
oai:figshare.com:article/34035303
2026-09-30T17:33:01Z
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<p>TREND statement checklist.</p>
Julio Carlos Vélez de Lachica (25145304)
Susana Serrano (683489)
Eduard Vidovic (10071489)
Antonio Farfan (25145307)
Medicine
Neuroscience
Physiology
Biotechnology
Immunology
Mental Health
treatment &# 8217
generalized estimating equations
also showed within
81 – 20
52 – 21
showed consistent improvement
patellofemoral joint loading
clinically meaningful improvement
subgroup analyses assessed
findings support intra
related knee pain
describe longitudinal changes
bmi subgroup (<
koos scores increased
2 </ sup
predefined ikdc threshold
sorbitol injection outcomes
xlink "> athletes
patellofemoral pain
longitudinal changes
xlink ">
n </
koos threshold
koos scores
improvement rate
group improvement
clinical outcomes
knee function
estimated changes
sorbitol injection
tolerated option
small elevated
sensitivity analysis
potential influence
may contribute
functional limitation
frequent cause
exploratory regression
exploratory comparisons
controlled trials
ci 17
ci 16
body weight
athletic populations
6 months
<div>
<p>Background</p><p>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.</p>
<p>Objective</p><p>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.</p>
<p>Methods</p><p>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.</p>
<p>Results</p><p>Mean IKDC and KOOS scores increased from baseline to 6 months, with estimated changes of +18.58 points for IKDC (95% CI 16.81–20.36) and +19.28 points for KOOS (95% CI 17.52–21.04; both p < 0.001). At 6 months, 75.0% of participants reached the predefined IKDC threshold for clinically meaningful improvement and 83.3% reached the KOOS threshold. Participants with BMI ≥ 25 kg/m<sup>2</sup> also showed within-group improvement. BMI was not independently associated with improvement rate after adjustment for baseline score; however, the small elevated-BMI subgroup (<i>n</i> = 22) limited these exploratory comparisons, and a clinically relevant difference could not be excluded. Minor local adverse events occurred in 4 of 60 participants and resolved with cryotherapy.</p>
<p>Conclusion</p><p>Athletes with PFP, including those with elevated BMI, showed consistent improvement in knee function and symptoms over 6 months following hyaluronic acid–sorbitol injection. These findings support intra-articular hyaluronic acid–sorbitol as a feasible, well-tolerated option for athletes with PFP, regardless of body weight. Controlled trials are needed to confirm the treatment’s contribution, given the single-arm design.</p>
<p>Trial Registration</p><p>CEI/0504/PI/2022; ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT05450458" target="_blank">NCT05450458</a>.</p></div>
2026-09-30T17:32:58Z
Text
Journal contribution
10.1371/journal.pone.0346269.s003
https://figshare.com/articles/journal_contribution/_p_TREND_statement_checklist_p_/34035303
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