Intraosseous infiltrations of Platelet-Rich Plasma for severe hip osteoarthritis: A pilot study

Nicolás Fiz; Diego Delgado; Ane Garate; Pello Sánchez; Jaime Oraa; Ane Miren Bilbao; Jorge Guadilla; Mikel Sánchez

doi:10.1016/j.jcot.2019.12.012

Intraosseous infiltrations of Platelet-Rich Plasma for severe hip osteoarthritis: A pilot study

J Clin Orthop Trauma. 2020 Jul;11(Suppl 4):S585-S590. doi: 10.1016/j.jcot.2019.12.012. Epub 2019 Dec 28.

Authors

Nicolás Fiz¹, Diego Delgado², Ane Garate², Pello Sánchez², Jaime Oraa¹, Ane Miren Bilbao¹, Jorge Guadilla¹, Mikel Sánchez^{1

2}

Affiliations

¹ Arthroscopic Surgery Unit, Hospital Vithas San José, Vitoria-Gasteiz, Spain.
² Advanced Biological Therapy Unit, Hospital Vithas San José, Vitoria-Gasteiz, Spain.

Abstract

Objective: Addressing the subchondral bone through intraosseous infiltrations of Platelet-Rich Plasma (PRP) may improve the effectiveness of this technique for severe hip osteoarthritis (HOA).

Methods: Forty patients with HOA degree 2 and 3 according to the Tönnis scale were recruited for this study. They were susceptible to a total hip arthroplasty, without response to previous treatment based on intraarticular infiltrations of PRP. Patients received a combination of intraosseous injections into the acetabulum and the femoral head, as well as intraarticular PRP infiltrations. The clinical outcome was evaluated at 2, 6 and 12 months using the Hip Osteoarthritis Outcome Score (HOOS) and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index.

Results: At 2, 6 and 12 months, patients had significant pain improvement according to HOOS pain, WOMAC pain, and VAS scores. After the treatment, the percentage of patients with minimal clinically important improvement was 40% (16 over 40 patients) at 2 months, 37.5% (15 over 40) at 6 months, and 40% (16 over 40) at 12 months. Conclusion: The combination of intra-articular and intra-osseous infiltrations of PRP showed a pain reduction and improvement in hip joint functionality up to 12 months in patients with severe HOA, with no severe adverse effects.

Keywords: Hip osteoarthritis (HOA); Intraosseous infiltration; Platelet-rich plasma (PRP); Treatment.