Pharmacological treatment withcorticoid or hyaluronic acid injections into subtalar joint via lateral access v1

Abstract

Pharmacological treatment, such as corticoid or hyaluronic acid intra-articular injections, is consistently used for osteoarthritis cases in which conservative treatment failed. The use of intra-articular injections aims to decrease pain and restore function, at least partially and temporarily [1]. Nonetheless, the indication for foot joint injection is restricted, especially for the subtalar joint, since there is a lack of reports which provide technical information on this subject. This protocol provides a step-by-step guide for performing subtalar intra-articular injection, which is a simple procedure that consists of inserting a needle in the subtalar joint to dispense pharmacological treatment directly in contact with the tissues committed by osteoarthritis. Since the intra-articular injection technique is invasive, there is a need to be cautious about performance to minimize risks of infection, discomfort, lesions and pain. For this, orthopedists might employ some methodological precautions as well as take special care regarding joint access. The lateral route is easy to perform since it uses the anterior edge of the lateral malleolus tip as a landmark. Beyond that, there are no neurovascular bundles or tendons in the needle's path. However, in our literature searches, we did not identify records considering this route, except for previous articles by our group [2,3], which showed positive effects of corticoid and principally hyaluronic acid injections. Thus, we point the lateral access as a safe route, reinforcing the need to disclose this technique.