Orthobiologic Injections for the Treatment of Hip Osteoarthritis: A Systematic Review

Zaffagnini, Marco; Boffa, Angelo; Andriolo, Luca; Raggi, Federico; Zaffagnini, Stefano; Filardo, Giuseppe

doi:10.3390/jcm11226663

Cited by 7 publications

(7 citation statements)

References 55 publications

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“…[14][15][16] However, most evidence on the clinical effectiveness of IA-HA comes from research on knee OA, 17,18, while the effects reported for the hip, shoulder, and ankle joints are limited. 17 The evidence suggests that IA-HA products with high MW; defined as greater than 3,000 kDa) have better effectiveness and safety for OA of the knee than lower MW products. 13,18,19 Why Is it Important to Do This Review?…”

Section: Context and Policy Issuesmentioning

confidence: 99%

Intra-Articular Hyaluronic Acid for Osteoarthritis of the Hip, Shoulder, and Ankle

Barbara,

Ritchie,

Severn

2024

cjht

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What Is the Issue? Osteoarthritis (OA) is a chronic disease of the joints, such as the hip, shoulder, and ankle. OA causes the joints to be painful, unstable, and less functional. In adults 55 years and younger, joint trauma is a common cause of OA. Hyaluronic acid (HA) is a naturally occurring molecule found in human cells that provides lubrication when injected into the joint. HA injections are a less invasive option than surgery, with potentially fewer complications. To support decision-making about treating hip, shoulder, or ankle OA in adults 55 years and younger, it is important to understand the potential benefits and harms of using HA in this population. What Did We Do? We reviewed the clinical effectiveness of high molecular weight (MW) injection of HA in adults between the ages of 18 and 55 years with OA of the hip, shoulder, or ankle joints to guide decisions on the use of high MW HA injection. An information specialist searched for peer-reviewed and grey literature sources published on January 1, 2013 to December 12, 2023. One reviewer screened citations and selected and critically appraised the included studies. What Did We Find? The evidence for this report was based on observational before-and-after studies. We found no relevant comparative studies examining the effect of high MW HA versus placebo or no treatment. While most studies reported post-treatment outcome improvements, it is uncertain whether high MW injection of HA improves pain, function, and disability in adults 55 years and under with hip, shoulder, or ankle OA. This is due to the low-quality evidence, small sample sizes, and methodological problems. Serious side effects of high MW HA were not reported. What Does This Mean? Due to the uncertainty of the clinical effectiveness evidence, health care providers and decision-makers may consider other factors when considering high MW IA-HA for patients with hip, shoulder, or ankle OA; these factors could include acceptability, feasibility, costs, health equity, and patient values and preferences. Future research from randomized studies in large populations is needed to understand the effectiveness and safety of high MW HA injections for hip, shoulder, and ankle OA.

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Section: Context and Policy Issuesmentioning

confidence: 99%

Intra-Articular Hyaluronic Acid for Osteoarthritis of the Hip, Shoulder, and Ankle

Barbara,

Ritchie,

Severn

2024

cjht

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“…Newer orthobiologic therapies like Platelet-Rich Plasma (PRP) or stem cell hip injections are also becoming more commonly seen in treatment for hip OA. These injections aim to alleviate pain and improve joint function in individuals with hip OA by harnessing the regenerative properties of the injected substances [22]. Studies investigating hip injections, particularly PRP and cell-based therapies, have shown promising results in reducing hip pain and enhancing joint function [22].…”

Section: Current Treatment For Common Hip Conditionsmentioning

confidence: 99%

“…These injections aim to alleviate pain and improve joint function in individuals with hip OA by harnessing the regenerative properties of the injected substances [22]. Studies investigating hip injections, particularly PRP and cell-based therapies, have shown promising results in reducing hip pain and enhancing joint function [22]. However, the evidence is still evolving with limitations including heterogeneity in injected products and the need for further high-quality research to establish their efficacy and optimize treatment protocols [22].…”

Section: Current Treatment For Common Hip Conditionsmentioning

confidence: 99%

“…Studies investigating hip injections, particularly PRP and cell-based therapies, have shown promising results in reducing hip pain and enhancing joint function [22]. However, the evidence is still evolving with limitations including heterogeneity in injected products and the need for further high-quality research to establish their efficacy and optimize treatment protocols [22]. Severe cases call for surgical interventions including hip arthroscopy, total hip arthroplasty or osteotomy.…”

Section: Current Treatment For Common Hip Conditionsmentioning

confidence: 99%

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Potential Stem Cell Treatment for Common Hip Conditions: Osteoarthritis, Osteonecrosis and Gluteal Tendinopathy

Gallicchio

2024

JRMBR

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Hip pathology, encompassing common conditions such as Osteoarthritis (OA), Osteonecrosis (ONFH) and gluteal tendinopathy, presents significant challenges in clinical management which often necessitate innovative treatment modalities. Stem cell therapy has emerged as a promising approach for addressing these complex hip conditions by promoting tissue regeneration and modifying disease progression. This paper aims to review the current literature on stem cell therapy for hip pathology, focusing on its application in OA, ONFH and gluteal tendinopathy. A comprehensive review of relevant studies and clinical trials was conducted by examining the safety, efficacy and potential mechanisms of action of stem cell therapy in hip conditions. Studies investigating the use of Bone Marrow-Derived Mesenchymal Stem Cells (BMMSCs), Adipose-Derived Mesenchymal Stem Cells (ADMSCs) and Tendon-Derived Stem Cells (TDSCs) were included in the analysis. The reviewed studies demonstrate promising outcomes of stem cell therapy in improving pain, functionality and halting disease progression in patients with hip OA. Intra-articular injections of MSCs have shown sustained benefits and arrested the progression of osteoarthritis. Stem cell therapy has also shown effectiveness in delaying the progression of ONFH, reducing femoral head collapse and decreasing the need for total hip replacement. Furthermore, in cases of gluteal tendinopathy, stem cell therapy has exhibited significant improvements in pain and functionality in a limited number of studies on the topic and also offers sustained relief in patients unresponsive to conventional treatments. Stem cell therapy holds immense potential as a safe and effective intervention for hip pathology and offers disease-modifying effects and sustained clinical benefits in these prevalent conditions. Further research is warranted to optimize treatment protocols, clarify mechanisms of action and validate long-term efficacy in larger cohorts.

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“…Despite these challenges, treating damaged cartilages by MSC is promising, and further research in this area could lead to new and effective treatments for this debilitating condition. 8 , 40 , 41 …”

Section: Cellular Therapymentioning

confidence: 99%

Current and Novel Therapeutics for Articular Cartilage Repair and Regeneration

Cong¹,

Sun²,

Zhao³

et al. 2023

TCRM

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Articular cartilage repair is a sophisticated process that has is being recently investigated. There are several different approaches that are currently reported to promote cartilage repair, like cell-based therapies, biologics, and physical therapy. Cell-based therapies involve the using stem cells or chondrocytes, which make up cartilage, to promote the growth of new cartilage. Biologics, like growth factors, are also being applied to enhance cartilage repair. Physical therapy, like exercise and weight-bearing activities, can also be used to promote cartilage repair by inducing new cartilage growth and improving joint function. Additionally, surgical options like osteochondral autograft, autologous chondrocyte implantation, microfracture, and others are also reported for cartilage regeneration. In the current literature review, we aim to provide an up-to-date discussion about these approaches and discuss the current research status.

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Orthobiologic Injections for the Treatment of Hip Osteoarthritis: A Systematic Review

Cited by 7 publications

References 55 publications

Intra-Articular Hyaluronic Acid for Osteoarthritis of the Hip, Shoulder, and Ankle

Intra-Articular Hyaluronic Acid for Osteoarthritis of the Hip, Shoulder, and Ankle

Potential Stem Cell Treatment for Common Hip Conditions: Osteoarthritis, Osteonecrosis and Gluteal Tendinopathy

Current and Novel Therapeutics for Articular Cartilage Repair and Regeneration

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