There is a growing interest on regenerative medicine and platelet-rich plasma (PRP), with the aim of finding a conservative alternative to prosthetic surgery in hip osteoarthritis (OA). Currently, no study is available in the literature evaluating the treatment of OA with cordonal PRP (PRP-C) injections. The aim of this study was to verify the efficacy and safety of PRP-C injections in comparison with autologous PRP (PRP-A) in hip OA treatment.
After ethics committee approval, 100 patients under the age of 65 (mean 48 years old) and suffering from symptomatic unilateral hip OA of medium degree (1-3 Tonnis), were consecutively treated with 3 weekly ultrasound-guided PRP injections at our institution. Patients were divided into two groups: 50 patients treated with PRP-A, 50 patients with PRP-C. Clinical evaluations before the treatment, and after 2, 6, and 12 months were performed by HHS, WOMAC and VAS scores.
Two patients in PRP-C group were lost at follow-up, 1 patient of the same group was excluded as screening failure (Tonnis 4). No major adverse events have been recorded during follow-up. Overall, the improvement was limited with both treatments. Statistical analysis revealed a significant decrease in VAS (p = 0.031) and a significant improvement in HHS (p = 0.011) at 2 months with PRP-C. The clinical outcome was influenced by the Tonnis degree, with a scarce benefit in the more advanced OA cases.
PRP-C has shown an excellent safety profile, although it offers only a modest and short-term clinical improvement. The results are influenced by the degree of OA. Further studies with larger case series are needed to confirm the most suitable indications and potential of these biological injective approaches.