Platelet-rich plasma injections for hip osteoarthritis : a systematic review

Abstract

Osteoarthritis (OA) is the most prevalent type of joint disorder. Symptomatic hip OA was observed in 9.2% of adults aged 45 and above, with 27% displaying radiographic evidence of the condition. While there is no definitive cure for OA, numerous research studies have explored the application of PRP (Platelet-Rich Plasma) for addressing knee OA, there is a relatively limited number of investigations dedicated to hip OA. It is important to note that the hip joint possesses distinct characteristics compared to the other three joints. Therefore, in this systematic review, we wanted to focus on hip osteoarthritis and gave a brief update from the previous studies. This systematic review was conducted in accordance with the Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines. All randomized control trials that compared injection of Platelet-Rich Plasma and Hyaluronic Acid in hip osteoarthritis patients using English language from 2018 until 2023 will be included. Six studies involved in this study with total samples of 237 in PRP group and 220 in HA group.  The injection site, injection volume, number of injections, interval, and follow up were varied between these studies. All of the patients are undergoing treatment with ultrasound-guided intraarticular injections of PRP. The outcomes tabulated were Visual Analog Scale (VAS), Harris Hip Score (HHS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score which showed improvements from the baseline. All of the studies showed improvement of the score from the baseline. Although, there were improvements, it can be concluded that there was not enough evidence to promote the utilization of intra-articular PRP injections as a treatment for hip osteoarthritis. Since international guidelines only recommend intra-articular steroid injections for managing hip OA, it would be advantageous to conduct additional studies comparing PRP to steroids to assess the effectiveness of PRP injections in treating hip OA.