Platelet Rich Plasma for treating Hip Osteoarthritis

Danielle.Steilen.ProlotherapistDanielle R. Steilen-Matias, MMS, PA-C

Our offices have been offering regenerative medicine injections since 1993 as a service to people who wish to avoid hip replacement surgery. As part of our comprehensive program, we offer Platelet Rich Plasma Therapy, or as we describe it Platelet Rich Plasma Prolotherapy.

  • If you have come upon this page, it is likely that you have received a recommendation to Platelet Rich Plasma Injections for your hip pain and you are doing your research.

We are going to help you with that research, but first I would like to take a moment to describe how we offer Platelet Rich Plasma Injections for your hip pain as opposed to how you may have been offered this treatment in other offices.

  • In another office, Platelet Rich Plasma treatment may have been explained to you as a one-time injection treatment. You may have been told this one injection will help with your problems of hip joint erosion and address the concern of irreversible hip damage.
  • In Platelet Rich Plasma treatment, your blood is drawn from your arm, it is spun to concentrate the blood platelets which contain concentrated healing elements. The concentrated plasma “rich in healing platelets” solution is then injected into your hip.

This is not how we offer this treatment.

In our experience when somebody has degenerated hip disease and the cartilage is wearing away and being lost, you simply cannot repair the cartilage without addressing what is causing the cartilage damage. This is the joint erosion or irreversible joint damage you are hearing so much about. It manifests itself as instability in your hip, the feeling that your hip is giving way or is loose and wobbly.

  • It is important that anyone contemplating treatment with platelet-rich plasma therapy should address the instability issue by adding comprehensive Prolotherapy treatments to the PRP treatments.

Prolotherapy is an injection of a simple dextrose, a sugar. The dextrose initiates soft tissue repair. In the hip, the treatment is used to repair, tighten and strengthen the ligaments that hold the hip bones in place.

Prolotherapy, by itself, is a very effective treatment. We may turn to Platelet Rich Plasma injections when damage to the hip cartilage is more substantial. We never give PRP to the hip without Prolotherapy.

In our published research we looked at 61 patients, 33 of them had hip pain in both hips. Twenty of these patients were told that there were no treatment options available to them, with eight being recommended to surgery as their “only hope,” for hip pain alleviation.

Of the 94 hips treated in the 61 patients:

  • 89% experienced more than 50% of pain relief with Prolotherapy;
  • more than 84% showed improvements in walking and exercise ability, anxiety, depression and overall disability;
  • 54% were able to completely stop taking pain medications.(9)

In this video for athletes and active patients, a demonstration of the type of Comprehensive Prolotherapy offered at Caring Medical is shown.

  • This should also be seen as a demonstration of how Prolotherapy can help get the worker back to the job, and the hip osteoarthritis patient back to mobility. In the video, the patient is comfortable in receiving these injections.

In this video, you also see that the injections are not only targeted at the center of the joint, as in PRP injections but also around the joint. What this does is address joint instability by treating the ligaments of the peri-articular or “outside” hip region.

The evidence for PRP in hip regeneration

It is somewhat amazing that the bulk of research surrounding the use of PRP into the hip is focused on how to make wound healing better during after invasive surgery. It is amazing because patients seek PRP not to make their surgery wound go away, but to make the surgery go away.

  • In October 2018, in the journal Medicine, doctors found that PRP might prevent postoperative bleeding in total hip replacement patients. Postoperative bleeding can be a problem in many patients following hip replacement.(2)
  • In July 2018, in the Journal of Experimental Orthopaedics, doctors wrote of the possible extensive tendon damage following hip replacement procedures. They suggested PRP may assist in the healing of these tendons. Extensive tendon damage could be a problem for some patients getting a hip replacement and severely impact the patient’s ability to walk correctly after surgery.(3)

The evidence that PRP helps avoid a surgery.

In one case published in PM & R: the journal of injury, function, and rehabilitation PRP was found very effective for advanced-stage degenerative AVN of the hip, with the patient demonstrating significant functional improvements and the ultimate outcome of being able to avoid surgery.(4)

In a study from doctors at the University of Florence, researchers found that a majority of patients receiving PRP for hip osteoarthritis had significant pain reduction at 6-7 weeks, which was sustained at 6 months, with a better range of motion.(5)

Researchers from the Rizzoli Orthopedic Institute in Italy published their findings in the American Journal of Sports Medicine which showed intra-articular PRP injections offered a significant clinical improvement in patients with hip osteoarthritis without relevant side effects.(6)

PRP may not work if the doctor considers PRP to be a one-time treatment

There are numerous studies that show a lack of effectiveness in PRP treatments. These studies surround the single-dose/injection treatment. It should make sense to anyone researching the use of PRP for hip osteoarthritis that it is unlikely that you can reverse years of degenerative hip disease with a single injection of anything. A degenerative disease does not happen overnight, nor does it reverse overnight.

  • If you are looking to avoid hip replacement with PRP, then consider it more than one injection in the doctor’s office.

There are more articles on our website surrounding the avoidance of hip replacement.

If you have questions about PRP for your hip pain, Get help and information from our Caring Medical staff

Prolotherapy Specialists

 

Hauser RA, Hauser MA. A Retrospective Study on Hackett-Hemwall Dextrose Prolotherapy for Chronic Hip Pain at an Outpatient Charity Clinic in Rural Illinois. Journal of Prolotherapy. 2009;2:76-88. [Google Scholar]

2 Wang X, Ma J, Wang Z, Xiao L. The clinical efficacy of using autologous platelet-rich plasma in total hip arthroplasty: A retrospective comparative study. Medicine. 2018 Oct 1;97(40):e12451. [Google Scholar]

3 Aavikko A, Puhakka J, Haapala J, Kukkonen J, Mäkelä K, Kosola J. Perioperative platelet rich plasma (PRP) in total hip arthroplasty through the Hardinge approach: protocol to study the effectiveness for gluteus medius healing. Journal of Experimental Orthopaedics. 2018 Dec 1;5(1):23. [Google Scholar]

4. Ibrahim V, Dowling H. Platelet-rich plasma as a nonsurgical treatment option for osteonecrosis. PM R. 2012 Dec;4(12):1015-9. doi: 10.1016/j.pmrj.2012.07.009.  [Google Scholar]

5. Civinini R, Nistri L, Martini C, Redl B, Ristori G, Innocenti M. Growth factors in the treatment of early osteoarthritis. Clinical Cases in Mineral and Bone Metabolism. 2013;10(1):26-29. doi:10.11138/ccmbm/2013.10.1.026. [Google Scholar]

6. Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, Tschon M, Giavaresi G. Ultrasound-guided injection of platelet-rich plasma and hyaluronic acid, separately and in combination, for hip osteoarthritis: a randomized controlled study. The American journal of sports medicine. 2016 Mar;44(3):664-71. [Google Scholar]

 

 

 

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