Comparing Intra-articular Injections of Leukocyte-Poor Platelet-Rich Plasma Versus Low-Molecular Weight Hyaluronic Acid for the Treatment of Symptomatic Osteoarthritis of the Hip: A Double-Blind, Randomised Pilot Study
Hyaluronic acid (HA) and leukocyte-poor platelet-rich plasma (LP-PRP) are 2 popular successful nonoperative treatment options that have been studied in patients with hip osteoarthritis (OA).
Methods: A total of 34 patients (36 hips) presenting with signs of hip OA were randomised to receive 3 blinded, weekly intra-articular injections of either LP-PRP or LMW-HA. Patients were prospectively evaluated before injections and at 6 weeks and then at 3, 6, 12, and 24 months. The primary outcome, conversion to total hip surgery or a hip resurfacing procedure, was analysed along with secondary outcomes including pain score and hip range of motion.
Results: The final analysis included 33 hips in 31 patients. Significantly more patients converted to THA or a hip resurfacing procedure in the LMW-HA group than the LP-PRP group.There was no significant improvement or decline in any outcome scores within the LMW-HA group from before injections to 6 weeks or 3, 6, and 12 months. For the LP-PRP group, pain and function scores significantly improved from before injections to 6 weeks, andjoint scores significantly improved from before injections to 6 months. When comparing the difference between groups in internal rotation at 90° of hip flexion from before injections to 6 months, the LP-PRP group demonstrated a mean 5.0° improvement, while the LMW-HA group showed a mean 1.5° decrease.
Conclusion: Intra-articular hip injections of LP-PRP in patients with hip OA resulted in an improvement in pain and function scores and hip internal rotation at 6 months and delayed the need for total hip surgery 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.
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