Treatment of Early Hip Osteoarthritis: Ultrasound-Guided Platelet Rich Plasma versus Hyaluronic Acid Injections in a Randomized Clinical Trial

Abstract

Purpose The aim of this study was to compare the clinical efficacy of ultrasound-guided intra-articular injections of autologous platelet rich plasma (PRP) versus hyaluronic acid (HA) for symptomatic early osteoarthritis (OA) of the hip. Methods A prospective controlled double-blinded randomized trial on 80 patients with hip OA was conducted. The patients were divided in two groups of 40 patients each: group 1 underwent three PRP intra-articular ultrasound-guided injections, whereas group 2 underwent three HA injections. WOMAC, VAS, and Harris Hip Score were evaluated for both groups before and at 6 and 12 months after treatment. Results The two groups were comparable in age, sex, body mass index, and severity of hip OA. Both groups showed a significant improvement from baseline at 6-month and 12-month follow-ups for all the outcome measures. No major complications were observed during the treatment and at follow-ups in both the groups. Conclusion PRP did not offer significantly better results compared with HA in patients with moderate signs of OA, and thus it should not be considered as first-line treatment. Level of Evidence Level II, randomized controlled trial.

Freeze-Dried Platelet-Rich Plasma Induces Osteoblast Proliferation via Platelet-Derived Growth Factor Receptor-Mediated Signal Transduction

“…Thus, PRP is emerging as a novel treatment for musculoskeletal pathologies, such as ligament injury, muscle tears, tendinopathies, and osteoarthritis [5,6]. For instance, intra-articular injections of autologous PRP are effective in patients with moderate osteoarthritis [7]. In previous studies, we showed that PRP accelerated bone union and induced a reduction of the bone union period in both rats and humans with spinal posterolateral fusion (PLF) [8][9][10].…”

Preparation Methods and Clinical Outcomes of Platelet-Rich Plasma for Intra-articular Hip Disorders: A Systematic Review and Meta-analysis of Randomized Clinical Trials

“…3,13,41 Two studies used 10% calcium chloride, 3,13 and 1 study used an undisclosed exogenous activator. 41 Three studies 14,15,29 (42.9%) did not mention whether an activator was used, and 1 study 42 (14.3%) specifically reported not using an activator. Detailed PRP preparation information is reported in Table 2.…”

Measures of Hip Function and Symptoms

“…Both the HHS and the modified HHS have been used extensively in clinical trials involving hip pathology and treatment of different hip conditions. The HHS has been used in trials that range from assessment of treatment choice for femoral neck and intertrochanteric femur fractures to assessment of effectiveness of different injections for osteoarthritis of the hip . The HHS is also a popular tool in studies relating to THAs given the focus of the measure on pain and impaired physical function, which are the main indications for a THA .…”