Purpose
To systematically review the literature to compare the efficacy of platelet-rich plasma
(PRP) and hyaluronic acid (HA) injections for the treatment of hip osteoarthritis
(OA).
Methods
A systematic review was performed by searching PubMed, the Cochrane Library, and Embase
to identify randomized controlled trials that compared the clinical efficacy of PRP
and HA injections for hip OA. The search phrase used was hip, osteoarthritis, platelet-rich
plasma, hyaluronic acid, randomized. Patients were assessed based on the Western Ontario
and McMaster Universities Osteoarthritis Index (WOMAC), the Visual Analog Scale (VAS)
for pain, and the Harris Hip Score (HHS). Subanalyses were performed for any outcome
score in which ≥3 studies reported results.
Results
Six studies (5 level I, 1 level II) met inclusion criteria, including 211 patients
undergoing intra-articular injection with PRP (mean age 60.0 years, mean follow-up
12.2 months) and 197 patients with HA (mean age 62.3 years, mean follow-up 11.9 months).
No significant differences were found in the weighted improvement of any outcome score
(WOMAC, VAS, or HHS) from preinjection to postinjection between groups. When excluding
a study with the highest risk of bias to eliminate heterogeneity, pooled subanalysis
demonstrated no significant differences in WOMAC subscores between PRP and HA groups.
Similarly, in a pooled subanalysis that isolated patients treated with leukocyte-poor
PRP, no significant differences in WOMAC subscores were found between PRP and HA groups.
Conclusion
Patients undergoing treatment for hip OA with either PRP or HA injections can expect
to experience similarly beneficial short-term clinical outcomes.
Level of Evidence
II, systematic review of level I and II studies.
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Article Info
Publication History
Published online: November 13, 2021
Accepted:
November 3,
2021
Received:
May 30,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: O.M-D. reports royalties, Stryker; stock, MITA. J.L.D. reports paid consultant, BD , Biomet , Breg, CONMED Linvatec, DePuy, DJ Orthopaedics, Genzyme , Harvest Technologies, Joint Restoration Foundation , KCRN Research, Ossur, Regeneration Technologies, RNL Bio, Sideline Sports Docs, Zimmer . R.M.F. reports board membership, AOSSM , ISAKOS , Orthopedics Today, AAOS , American Orthopaedic Society for Sports Medicine , American Shoulder and Elbow Surgeons , Arthroscopy Association of North America , International Cartilage Restoration Society, Journal of Shoulder and Elbow Surgery; paid consultant, Allosource, Arthrex , JRF , Ossur; other, Ossur, JRF , Arthrex , Smith & Nephew. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 by the Arthroscopy Association of North America
