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Platelet-Rich Plasma for Hip Osteoarthritis

June 14, 2019

Health Problem: Osteoarthritis (OA) is a painful condition that occurs when the cartilage between the bones degenerates, no longer providing a smooth, gliding surface for motion or adequate cushioning. Damaged articular cartilage does not tend to heal and may progressively worsen and cause focal lesions and eventually OA. Hip OA is common. The estimated lifetime risk for symptomatic hip OA is 18.5% for men and 28.6% for women.

Technology Description: Platelet-rich plasma (PRP) is an autologous blood preparation with a higher-than-usual concentration of platelets, platelet-derived growth factor, and other cytokines. PRP preparation protocols vary considerably but always entail centrifugation of whole blood obtained from the patient to isolate platelets from other blood components. Injection into the intra-articular (IA) space of the hip joint is guided by ultrasonography.

Controversy: The use of PRP as a minimally invasive technique to treat symptoms of hip OA has increased in recent years. PRP is administered locally and has not been associated with severe or lasting adverse effects. However, there is considerable uncertainty with respect to the use of PRP to treat bone and cartilage disorders. The body of randomized controlled trial-based evidence lacks placebo-controlled studies and is limited to comparisons with hyaluronic acid (HA) but it remains uncertain whether HA is superior to placebo for hip OA and other indications. The durability of any effect of PRP is also unclear.

Key Questions:

  • Do IA-PRP injections reduce pain or improve function and quality-of-life outcomes for adult patients with hip OA?
  • Are IA-PRP injections safe for hip OA?
  • How do the efficacy and safety of IA-PRP injections for hip OA compare with other conservative treatment options?
  • Have definitive patient selection criteria been identified for IA-PRP for hip OA?