Cortisone Injections vs Viscosupplementation: Which method is better?

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65.,and%2037%25%20within%205%20years


This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.

Image Credits: Orthopaedic Specialists

Arthritis is an orthopaedic condition that often results in chronic joint pain. As a medical condition that is induced by the breakdown of joint cartilage, arthritis impacts general mobility and quality of life. 

Movement is natural to our daily lives, and with time, there is friction between the bones that is generated in the progression of arthritis. Inflammation of the joint results, causing the sensation of pain. Ankle joint pain is often the result of strenuous activity. Studies have shown that the majority of ankle arthritis cases are actually induced by some form of physical trauma. This includes sports related injury, falls and any other impacts or collisions that induce shock to the ankle. 

Ankle arthritis is a condition that is caused by degeneration of the internal conditions of the ankle joint cavity. Joint cartilage, and synovial fluid is often impacted. Patients often experience stiffness and inflammation in the joint cavity. In order to improve arthritis symptoms, cortisone shots are often administered. 

Cortisone shots are injected into the ankle joint, and they are made up of a corticosteroid medication infused with an anaesthetic. With all medicines, there are adverse effects and doctors often restrict the number of shots that patients can receive in a year. 

An alternative treatment for ankle arthritis patients is a procedure called viscosupplementation. Viscosupplementation is another injection based treatment that involves the injection of hyaluronic acid into the joint. Hyaluronic acid is a thick fluid, and it has the ability to minimise pain and swelling in the joint.  Because of the consistency of hyaluronic acid, it acts as a joint lubricant. As a close constituent to cartilage, the hyaluronic acid helps to restore the joint integrity. 

Viscosupplementation acts as a restorative treatment for patients who have osteoarthritis. As a degenerative condition, arthritis results in a wearing away of the joint cartilage and synovial fluid, and joints can rub together and induce friction. This condition causes pain and swelling in the joint. Hyaluronic acid is a naturally occurring constituent of the joint. Arthritic patients have less hyaluronic acid in their joints than healthy patients, and viscosupplementation is a supplement for this deficiency. 

How is viscosupplementation done? 

Viscosupplementation involves the injection of a mild anaesthetic into the space around the knee joint. If there is any fluid present in the joint, it may be drained. Draining any excess fluid in the joint creates a cavity that the hyaluronic acid can be injected into. With all treatments, you may need more than one dose in order to achieve the desired results. 

Which treatment is best for you? 

There are a variety of treatments that are available for ankle arthritis. This blog post only showcases two of the injection based options. Viscosupplementation is usually administered for mild to moderate cases of arthritis, since it relieves pain, stiffness and swelling in the joint. It is also a good method to either prevent or prolong your surgery. 

Cortisone injections are better administered for inflammatory cases of arthritis that tend to be more severe. With all cases of treatments, a discussion with your doctor is best held. 


  1. Mayo Clinic: Cortisone shots
  2. John’s Hopkins University: Viscosupplementation

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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