Caring Medical - Where the world comes for ProlotherapyPlatelet Rich Plasma therapy for treating Hip Osteoarthritis

Ross Hauser, MD  | Caring Medical Regenerative Medicine Clinics, Fort Myers, Florida
David N. Woznica, MD | Caring Medical Regenerative Medicine Clinics, Oak Park, Illinois
Danielle R. Steilen-Matias, MMS, PA-C | Caring Medical Regenerative Medicine Clinics, Oak Park, Illinois

The evidence for Platelet Rich Plasma therapy for treating Hip Osteoarthritis

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 try to offer help with that research, but first, we 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.

The thinking that PRP may only be a delaying treatment to put off hip replacement surgery

As described above, many patients come in with preconceived notions suggested to them by their orthopedists that PRP treatment is a one injection treatment, the effects will wear off, when the PRP effects wear off, surgery can then be discussed.

Despite evidence that PRP can help patients with hip osteoarthritis by addressing and correcting the destructive hip instability, there is a belief among many in the medical community that PRP is only a stopgap to delay the hip replacement surgery. By offering the patient that one-time treatment, they will be providing the patient significant pain relief until they are ready for hip replacement.

There are numerous studies that show a lack of effectiveness in PRP treatments. These studies surround 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.

Our experience in treating thousands of patients, we have not found PRP to be effective as a single dose treatment.


We have found it to be very effective as part of a comprehensive multi-dose treatment program

PRP treatments for hip pain will not help everyone. But because of the great variation in treatments researchers suggest that it is difficult to tell who the treatment can help and who the treatment will not help.

Single PRP treatment is not how we see PRP treatments. We see PRP treatments in conjunction with Prolotherapy treatments as a means to not only delay the need for a hip replacement but to prevent the need for hip by repairing and regenerating tissue in the hip. We see this as a best chance for success. Even then, our treatments do not work for everyone.

In our experience, when somebody has degenerative 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.

Prolotherapy utilizes hypertonic dextrose, among other simple ingredients that are individualized to each case, to initiate localized 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 add Platelet Rich Plasma as part of the Prolotherapy treatment when damage to the hip cartilage is more substantial. We never give only PRP into the hip without Prolotherapy to the surrounding, supportive ligaments.

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:

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

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.

PRP does not work for everyone. Your candidacy for treatment should be carefully evaluated

There are some doctors who warn against PRP use. Doctors at the Keck School of Medicine of USC, wrote in the journal Current reviews in musculoskeletal medicine, (2) December 2018, “PRP is a costly treatment not covered by insurance, and clinical trials have not demonstrated definitive efficacy, we recommend informing patients when providing PRP ‘off-label.” Like any medical treatment, PRP will not fix everything, for some patients PRP will not work for their hip pain for various reasons, generally speaking, a condition of hip degenerative disease that is “too far gone.”

Further doctors stress that patients be evaluated for realistic candidacy of treatment. PRP should only be offered when there is a realistic expectation that the patient is considered a good candidate for treatment success. A multinational team of researchers also writing in the journal Current reviews in musculoskeletal medicine (3) June 2019 suggested: “Although PRP is safe to use and it can be easily applied in the clinics, case-specific considerations are needed to determine whether PRP could be beneficial or not. If the use of PRP is favored, then, the configuration/optimization of the preparation and administration/delivery strategy with or without a concomitant treatment may further enhance the clinical outcomes and patients’ experience.”

A third paper in the journal Current reviews in musculoskeletal medicine (4) December 2018 from Stanford University suggested: “PRP is a promising treatment for some musculoskeletal diseases; however, evidence of its efficacy has been highly variable depending on the specific indication. Additional high-quality clinical trials with longer follow-up will be critical in shaping our perspective of this treatment option.”

The evidence for PRP in hip injury repair

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 to avoid surgery.

Can PRP help avoid a surgery?

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

1 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 Jones IA, Togashi RC, Vangsness CT. The economics and regulation of PRP in the evolving field of orthopedic biologics. Current reviews in musculoskeletal medicine. 2018 Dec 1;11(4):558-65. [Google Scholar]
3 Cengiz IF, Pereira H, Espregueira-Mendes J, Reis RL, Oliveira JM. The Clinical Use of Biologics in the Knee Lesions: Does the Patient Benefit?. Current reviews in musculoskeletal medicine. 2019 Sep 15;12(3):406-14. [Google Scholar]
4 Le AD, Enweze L, DeBaun MR, Dragoo JL. Current clinical recommendations for use of platelet-rich plasma. Current reviews in musculoskeletal medicine. 2018 Dec 1;11(4):624-34. [Google Scholar]
5 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]
6 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]
7. 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]
8. 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]
9. 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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Caring Medical Florida
9738 Commerce Center Ct.
Fort Myers, FL 33908
(239) 308-4701 Phone
(855) 779-1950 Fax Fort Myers, FL Office
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715 Lake St., Suite 600
Oak Park, IL 60301
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National Prolotherapy Centers specializing in Comprehensive Prolotherapy,
Stem Cell Therapy, and Platelet Rich Plasma.

Meet our Prolotherapy Doctors and check out our Prolotherapy research.