Hip Problems

Quick summary: Addition of PRP to MFAT (LipoGems) led to a 10% increase in patients with overall improvement in their hip arthritis symptoms. 75% with MFAT and PRP compared to 65% with MFAT alone

Full summary: ⅔ in both groups super-responder (VAS drop of >20 points), 65% in MFAT and 75% MFAT +PRP improved overall

Quick summary: Comparison of PRP to corticosteroid in gluteus medius and minimus tendinopathy with PRP group showing greater improvement than steroid at 12 weeks and 24 weeks, with improvement sustained at 2 years for PRP and between 6-24 weeks for steroid.

Full summary: 80 patients with chronic gluteal tendinopathy randomized 1:1 to receive LR-PRP and CSI, mean mHHS improved significantly at 12 weeks in PRP group (74.05; SD, 13.92) as compared with the CSI group (67.13; SD, 16.04) (P = .048). At 24 weeks, the LR-PRP group (77.60; SD, 11.88) improved further than the CSI group (65.72; SD, 15.28; P = .0003). Improvement after LR-PRP injection is sustained at 2 years, improvement from CSI is maximal at 6 weeks and not maintained beyond 24 weeks.

Quick summary: Examining multiple gluteal tendinopathy articles with a total of 1103 patients (1106 hips) that compare various treatment options with PRP, demonstrated that PRP had greater patient satisfaction at 12 weeks and statistically significant improvement in pain compared to physical therapy or cortisone.

Full summary: 27 articles considered, 1103 patients (1106 hips), treatment options were physical therapy, injections (corticosteroids, PRP, autologous tenocytes) with or without needle tenotomy/tendon fenestration, SWT, therapeutic ultrasound, or surgical procedures such as endoscopic or open tendon repair (with or without tendon augmentation). 2 studies with LR-PRP and CSI (mHHS score was significantly higher in the LR-PRP group at 12 weeks). Another study for single PRP with concomitant needle tenotomy of the gluteal tendons showed statistically significant and clinically important improvements in mHHS, HOS, and iHOT-33.

Quick summary: Comparing PRP studies to surgery studies for hip tendonitis that show significant improvement in pain in all studies included, although PRP showed a large effect size whereas surgery showed a moderate to large effect size

Full summary: 5 PRP and 5 surgery studies with 94 and 185 patients, respectively, Two studies in the PRP group (n = 56) reported improvements in the modified Harris Hip Score at final follow-up (from 53.8 to 82.6 and from 56.7 to 74.2), In the surgery group, 2 studies reported improvements in the Harris Hip Score (from 53.0 to 80 and from 53.3 to 88), although significant improvement was reported in all studies included, PRP showed a large effect size whereas surgery showed a moderate to large effect size.

Quick summary: When comparing PRP with steroid injection for hip tendonitis in around 100 hips (over 5 studies), PRP demonstrated a significant advantage with 82% achieving improvement compared to only 56.7% in the steroid group. PRP demonstrated a decrease in mean pain scores from 31.4 at baseline to 19.4 at 2 weeks.

Full summary: 5 studies (3 RCTs and 2 cases series), 102 hips (samples sizes 10-40 patients), PRP demonstrated a significant advantage compared with corticosteroid groups over 12 weeks (mean mHHS 74.05 ± 13.92 versus 67.13 ± 16.04, respectively, P = 0.048). For MCID, 82% in the PRP group achieved improvement compared to 56.7% in the corticosteroid group (P = 0.016). The PRP group demonstrated mean pain scores of 31.4 (SD 7.3, range 11–41) at baseline, 25.5 (SD 8.8, range 9–40.5) at 1 week and 19.4 (SD 10.3, range 4–42) at 2 weeks, the authors reported significant pain score improvements comparing baseline with 1 and 2 weeks follow-up (P < 0.0001) with no difference between the groups (P = 0.1623)