American Academy of Orthopedic Surgeons (AAOS) Approves New Ankle Osteoarthritis Guideline

At its June 2026 meeting, the AAOS Board of Directors approved its first-ever clinical practice guideline for ankle arthritis. 

Key recommendations

• Strongly recommends against intra-articular hyaluronic acid alone, which demonstrated no benefit. However, when combined with corticosteroid, it may offer short-term pain relief.

• Moderate recommendation against intra-articular platelet-rich plasma, as current evidence shows no benefit compared to placebo for ankle osteoarthritis.

• The sole limited-strength recommendation supports group education and exercise programs, including home exercise, for patients with mild to moderate symptomatic ankle osteoarthritis who wish to avoid surgery. These programs may improve satisfaction, pain, and overall perceived outcomes. 

In addition, the guideline includes 11 consensus-based statements and one limited-strength option developed for areas where evidence was minimal or absent.

What this means for practice

Reconciling clinical judgment and evidence-based guidelines is a worthwhile exercise for all of us. Translating the best available evidence into a defensible baseline strengthens how we communicate with patients, insurers, and colleagues alike.