151 patients with osteoarthritis (OA) of the first metatarsophalangeal joint (MTPJ) were randomized to determine the efficacy of intra-articularly injected hyaluronan for symptomatic treatment of this condition. Patients received a single injection of either Hylan G-F 20 or saline placebo, and were followed for 6 months following the injection. The results indicated that there were no differences between groups in the improvement of pain, foot function and joint stiffness, and demonstrated that a single intra-articular injection of hyaluronan had no beneficial effect in the treatment of first MTPJ OA compared to placebo.