The use of platelet-rich plasma in the treatment of greater trochanteric pain syndrome: a systematic literature review

Abstract

This review aims to determine whether platelet-rich plasma (PRP) has any role in improving clinical outcomes in patients with symptomatic greater trochanteric pain syndrome (GTPS). A search of NICE healthcare database advanced search (HDAS) via Athens (PubMed, MEDLINE, CINAHL, EMBASE and AMED databases) was conducted from their year of inception to April 2018 with the keywords: ‘greater trochanteric pain syndrome’ or ‘GTPS’ or ‘gluteus medius’ or ‘trochanteric bursitis’ and ‘platelet rich plasma’ (PRP). A quality assessment was performed using the JADAD score for RCTs and MINORS for non-RCT studies. Five full-text articles were included for analysis consisting of three RCTs and two case series. We also identified four additional studies from published conference abstracts (one RCT and three case series). The mean age in 209 patients was 58.4 years (range 48–76.2 years). The majority of patients were females and the minimum duration of symptoms was three months. Diagnosis was made using ultrasound or MRI. Included studies used a variety of outcome measures. Improvement was observed during the first 3 months after injection. Significant improvement was also noted when patients were followed up till 12 months post treatment. PRP seems a viable alternative injectable option for GTPS refractory to conservative measures. The current literature has revealed that PRP is relatively safe and can be effective. Considering the limitations in these studies, more large-sample and high-quality randomized clinical trials are required in the future to provide further evidence of the efficacy for PRP as a treatment in GTPS.Systematic Review RegistrationPROSPERO CRD42017080662Level of EvidenceLevel I, systematic review of Level I studies.

Ultrasound-guided Platelet-rich Plasma Application Versus Corticosteroid Injections for the Treatment of Greater Trochanteric Pain Syndrome: A Prospective Controlled Randomized Comparative Clinical Study

“…Some of them tried to compare the outcomes of PRP administration with other kinds of treatment [12,21]. A small number of these studies talk about the application of PRP injections in the treatment of GTPS and only a few of them compare this type of treatment with the use of CSI [22][23][24][25][26]. The purpose of our study was to evaluate and compare the outcomes of US-guided PRP injections against CSI in the treatment of GTPS.…”

Ultrasound-guided Musculoskeletal Interventions for the Most Common Hip and Pelvis Conditions: A Step-by-Step Approach

“…31 Regarding the use of PRP to treat gluteal tendinopathy, a recent meta-analysis showed it can be relatively safe and effective to treat this condition, although more established evidence is needed. 32…”

Chronic hip pain in adults: Current knowledge and future prospective

“…Recently, use of PRP has reported improvement in patients at 3- and 12-month follow up, but lacked high-quality evidence. [ 49 ] Surgery may be considered if these measures do not relieve symptoms and pain lasts longer than 1 year[ 47 ] Ultrasound-guided injection of greater trochanteric bursa is best approached with patient in lateral position with effected side up. Under strict asepsis, a linear probe in placed in the longitudinal plane to greater trochanter.…”

“…Recently, use of PRP has reported improvement in patients at 3- and 12-month follow up, but lacked high-quality evidence. [ 49 ] Surgery may be considered if these measures do not relieve symptoms and pain lasts longer than 1 year[ 47 ]…”