 PATIENTS : One hundred fifty-eight consecutive competitive athletes who suffered acute grade 0 or 0 lateral ankle sprains were randomized within 00 hours of injury . INTERVENTIONS : Patients were randomized at baseline to periarticular injection with hyaluronic acid ( HA ) + standard of care [ rest , ice , compression , and elevation ( RICE ) ] or placebo injection ( PL ) + standard of care ( RICE ) treatment at baseline assessment and on day 0 after injury . OUTCOMES MEASURES : Assessments at baseline and days 0 , 0 , 00 , and 00 included Visual Analogue Scale ( VAS ; 0-00 cm ) pain on weight bearing and walking 00 m , patient global assessment of ankle injury ( five-point categorical scale ) , patient satisfaction with treatment ( five-point categorical scale ) , time to return to pain-free and disability-free sport , and adverse events . Differences between groups were determined using an intent-to-treat analysis of variance . RESULTS : About 00% of the ankle sprains were "first" events , and no differences in clinical assessments with those presenting but not volunteering for the study ( n = 000 ) were observed . 