Platelet-rich plasma injections for hip osteoarthritis: a review of the evidence
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REVIEW ARTICLE
Platelet-rich plasma injections for hip osteoarthritis: a review of the evidence Mark Berney 1 & Paul McCarroll 1 & Liam Glynn 2 & Brian Lenehan 1,2 Received: 30 June 2020 / Accepted: 23 September 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Osteoarthritis is a significant cause of chronic pain in the elderly population with hip osteoarthritis as one of the main causes of functional disability and joint pain in adults older than 55 years. Recently, platelet rich plasma (PRP) injections have been introduced for treatment of osteoarthritis. The aim of this systematic review is to assess its effectiveness in the management of hip osteoarthritis. We performed a search of the literature for published prospective studies that assessed the effectiveness of PRP injections in the treatment of hip osteoarthritis, with a minimum follow-up of 3 months. Primary outcome measures were WOMAC and VAS scores. Five trials were identified with 185 patients undergoing treatment with ultrasound-guided intraarticular injections of PRP, compared with patients treated with hyaluronic acid alone (n = 148) or hyaluronic acid combined with PRP (n = 31) in one study. PRP was shown to improve patient outcome scores at follow-up at 6 and 12 months; however, there was no significant difference seen between patients treated with PRP or hyaluronic acid alone. Following this systematic review, we cannot currently recommend the use of intra-articular injections of PRP for the treatment of hip OA. Given that intra-articular steroid injections are the only such injection recommended by international guidelines for the treatment of hip OA, further studies comparing PRP to steroid would be of benefit to determine the value of PRP injections in hip OA. Keywords Cartilage . Orthopaedic . Osteoarthritis . Platelet-rich plasma . PRP
Introduction Osteoarthritis (OA) is one of the most common joint diseases, and it is one of the major causes of pain and disability in older adults [1]. This disability threatens the independence of older adults and has significant social and economic costs. It typically affects weight-bearing joints, with the hip the second most frequently involved large joint after the knee. The Key points • The use of platelet-rich plasma as a treatment modality has expanded so quickly that the research into its efficacy lags far behind. • The goal of this study is to determine if the use of PRP in hip osteoarthritis is a treatment that will benefit patients suffering from a debilitating illness. • This study cannot support the routine use of PRP in the treatment of hip osteoarthritis based on the studies performed to date. * Mark Berney [email protected] 1
University Hospital Limerick, Limerick, Ireland
2
University Limerick Graduate Entry Medical School, Limerick, Ireland
incidence of hip osteoarthritis continues to increase secondary to an ageing and overweight population [2]. Treatments for osteoarthritis include conservative measures (weight loss, physiotherapy, activity modification, supports) and p
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