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HIP
Hip biologic/regenerative medicine injections can be performed to treat a variety of conditions including bursitis, tendinitis, arthritis and labral injuries under ultrasound guidance. More research is continually being conducted to study the benefits of these treatments in many conditions such as Osteoarthritis, Gluteal/abductor tendinitis and tears, Bursitis, Labral injuries and Post surgical enhanced healing
Hip – Osteoarthritis
Results indicated that intra-articular PRP injections offer a significant clinical improvement in patients with hip OA without relevant side effects. The benefit was significantly more stable up to 12 months as compared with the other tested treatments. The addition of PRP+HA did not lead to a significant improvement in pain symptoms.
https://pubmed.ncbi.nlm.nih.gov/26797697/
Intra-articular hip injections of LP-PRP in patients with hip OA resulted in an improvement in WOMAC scores and hip internal rotation at 6 months and delayed the need for THA or a hip resurfacing procedure compared with treatment with LMW-HA. A longer follow-up is necessary to further compare the effects of LP-PRP and LMW-HA injections in patients with hip OA.
CS injections are recommended as the most efficient agent in hip OA patients in the short term. Moreover, PRP is reported to have the highest rank for pain relief for up to 6 months. Considering the limitations of this meta-analysis, future direct comparisons with more samples are needed.
https://pubmed.ncbi.nlm.nih.gov/31919027/
Steroid injection was found to be significantly more effective than placebo injection on reported pain at three months, but no significant difference was observed at six months. Furthermore, steroid injection was considerably more effective than placebo injection for functional outcomes at three months, while the combination of HA+PRP injection was substantially more effective at six months.
https://pubmed.ncbi.nlm.nih.gov/38821500/
Weak evidence suggests that viscosupplementation improves patient-reported pain and function at endpoint compared to baseline, regardless of dose, volume, composition and number of injections.
https://www.sciencedirect.com/science/article/abs/pii/S0749806323009398?dgcid=rss_sd_all
This study documents an association between hip corticosteroid injection and RDHD. While the risk of RDHD following a single low-dose (≤40 mg) triamcinolone injection is low, the risk is higher following high-dose (≥80 mg) injection and multiple injections. These findings provide information that can be used to counsel patients about the risks associated with this common procedure. In addition, caution should be taken with intra-articular hip injections utilizing ≥80 mg of corticosteroid and multiple injections.
https://pubmed.ncbi.nlm.nih.gov/34550909/
We found that approximately 7% of patients undergoing steroid hip injection developed RPIA (Rapidly progressive idiopathic arthritis of the hip). More advanced patient age, greater joint space narrowing, and more severe osteoarthritis are risk factors for the development of RPIA after intra-articular steroid injection.
https://pubmed.ncbi.nlm.nih.gov/34018006/
The prevalence of RPOH following intra-articular steroid injections into the hip was lower than previously reported but still clinically relevant. This should be considered when counseling patients prior to intra-articular hip steroid injections.
https://onlinelibrary.wiley.com/doi/10.1002/pmrj.12853?af=R
Hip – Impingement (FAI) and Labrum tears
Intraoperative PRP and CBT have been commonly reported in the setting of hip arthroscopy for labral repairs and acetabular chondral lesions, respectively. The CBT cohorts demonstrated more favorable PROM at most recent follow-up when compared to a control group, though these results should be interpreted with caution due to heterogeneity of orthobiologic preparations.
https://pubmed.ncbi.nlm.nih.gov/37906291/
Use of Platelet-Rich Plasma for the Treatment of Acetabular Labral Tear of the Hip: A Pilot Study. Ultrasound-guided injection of platelet-rich plasma holds promise as an emerging, minimally invasive technique toward symptom relief, reducing pain, and improving function in patients with hip labral tears.
https://pubmed.ncbi.nlm.nih.gov/31162277/
Hip - Gluteal tendinopathy
The present systematic review and meta-analysis showed that PRP injections for GTPS are more effective than injections of CCS.
https://pubmed.ncbi.nlm.nih.gov/34405857/
LR-PRP resulted in greater improvement in pain and function than corticosteroid injection. Effects were sustained at 2 years.
https://www.ncbi.nlm.nih.gov/pubmed/30840831
Both subfascial PRP injection and enthesis needling resulted in clinical improvements, but the improvement in the HOS-SS was greater in the PRP group.
https://pubmed.ncbi.nlm.nih.gov/38751852/
There was good evidence for using platelet-rich plasma in grades 1 and 2 tendinopathy. Shockwave therapy, exercise, and corticosteroids showed good outcomes, but the effect of corticosteroids was short term. Bursectomy with or without iliotibial band release was a valuable treatment option in grades 1 and 2 tendinopathy. Insufficient evidence was available to provide guidelines for the treatment of partial-thickness tears. There was low-level evidence to support surgical repair for grades 3 (partial-thickness tears) and 4 (full-thickness tears) tendinopathy. Fatty degeneration, atrophy, and retraction can impair surgical repair, while their effect on patient outcomes remains controversial.
https://journals.sagepub.com/doi/full/10.1177/23259671211016850
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