An Innovative Treatment Using sterile Hyaluronic Acid Injections to Reduce Foot Ulcer Recurrence in Patients with Diabetes: A Pilot Study

To evaluate whether plantar injection of hyaluronic acid using the Curacorn® technique can reduce ulcer recurrence in high-risk patients with diabetes. This pilot study included 14 patients with type 2 diabetes and a history of recurrent healed neuropathic or Charcot-related plantar foot ulcers. All ulcers were healed for at least 4 weeks prior to inclusion. Patients underwent 3-4 treatment sessions using a sterile, cross-linked hyaluronic acid gel implanted beneath previous ulcer sites. They were followed for 6-12 months to assess ulcer recurrence. Seven patients (50%) experienced no ulcer recurrence during the follow-up period of the study. Patients without recurrence received a higher total volume of hyaluronic acid when compared with those who experienced recurrence (mean 7.4 ml vs 3.9 ml). Ulcer recurrence in the remaining patients occurred after an initial ulcer-free period of approximately six months. In this pilot cohort, hyaluronic acid injection using the Curacorn® technique was associated with a reduction in ulcer recurrence, particularly when adequate gel volumes were administered. These findings support further investigation of this minimally invasive approach as a preventive strategy in high-risk diabetic foot patients.