<p>TREND statement checklist.</p>

Elevated body mass index (BMI) may contribute to patellofemoral joint loading, but evidence on hyaluronic acid–sorbitol injection outcomes in athletes with elevated BMI remains limited.</p> <p>Objective</p><p>To describe longitudinal changes in knee function and symptoms over 6 months after intra-articular hyaluronic acid–sorbitol injection in athletes with PFP, and to explore whether baseline BMI was associated with post-injection improvement.</p> <p>Methods</p><p>This prospective, single-arm, non-randomized interventional study included 60 athletes aged 30–55 years who received a single 4 mL intra-articular hyaluronic acid–sorbitol injection.

IKDC and KOOS scores were assessed at baseline, 15 days, 3 months, and 6 months. Longitudinal changes were evaluated using linear mixed models, with generalized estimating equations as a sensitivity analysis; exploratory regression and subgroup analyses assessed the association between BMI and improvement.</p> <p>Results</p><p>Mean IKDC and KOOS scores increased from baseline to 6 months, with estimated changes of +18.58 points for IKDC (95% CI 16.81–20.36) and +19.28 points for KOOS (95% CI 17.52–21.04; both p < 0.001).