Short-term clinical outcomes of cross-linked hyaluronic acid filler injection in the treatment of plantar fat-pad atrophy syndrome.

Background: Plantar fat-pad atrophy syndrome is characterized by thinning of the heel and forefoot fat pads, causing pain and functional limitation. Conventional treatments, such as heel cups and taping, offer only temporary relief and are often hindered by poor patient compliance.

Purpose: To evaluate the short-term clinical outcomes and complications of cross-linked hyaluronic acid (HA) filler injections into the plantar region of the foot.

Study design: Prospective case series.

Methods: Twenty-eight patients (30 feet) with plantar fat-pad atrophy received injections of cross-linked HA filler (YVOIRE® Contour Plus C, LG Chem, Ltd., Seoul, Korea). The primary outcome was change in Visual Analogue Scale (VAS) at 24 weeks. Secondary outcomes included EQ-5D-3 L, Foot and Ankle Outcome Score (FAOS), Foot Function Index (FFI), fat pad thickness, and patient satisfaction. Adverse events were recorded.

Results: VAS improved from 6.86 ± 1.67 to 3.50 ± 2.67 at 24 weeks (p < .001). EQ Index, FAOS, and FFI scores also improved significantly (all p < .05). Repeated measures ANOVA showed significant time effects across all clinical outcomes (p < .05). Fat pad thickness increased by 1.45 ± 1.59 mm at the heel and 2.67 ± 0.63 mm at the forefoot. Six patients experienced adverse events (pain, inflammation, and migration), all resolved conservatively.

Conclusion: Cross-linked HA filler injections provide short-term pain relief and functional improvement in plantar fat-pad atrophy. Future work should focus on optimizing filler materials, injection techniques, and rehabilitation protocols.