AAOS Issues First Ankle Osteoarthritis Guideline, Highlights Treatment Gaps
Event summary
- American Academy of Orthopaedic Surgeons (AAOS) released its first Clinical Practice Guideline for ankle osteoarthritis on July 2, 2026.
- Guideline includes only two evidence-based recommendations due to research gaps, with 11 consensus-based suggestions.
- Strong recommendation against using hyaluronic acid alone; moderate recommendation against platelet-rich plasma injections.
- Guideline emphasizes need for shared decision-making between patients and surgeons.
The big picture
This guideline marks a strategic recognition of ankle osteoarthritis as distinct from hip and knee OA, affecting younger patients. The limited evidence base highlights the need for more targeted research in this growing patient population. AAOS's move underscores the expanding treatment options and the challenge of balancing innovation with proven efficacy.
What we're watching
- Research Priorities
- How AAOS will address the identified evidence gaps in ankle osteoarthritis treatments.
- Insurance Coverage
- Whether payers will expand coverage for combination therapies like HA with corticosteroids.
- Treatment Adoption
- The pace at which orthopedic surgeons incorporate these guidelines into clinical practice.