PDF herunterladen
CC-BY-NC-ND 4.0 · Joints 2017; 05(03): 152-155
DOI: 10.1055/s-0037-1605584
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Treatment of Early Hip Osteoarthritis: Ultrasound-Guided Platelet Rich Plasma versus Hyaluronic Acid Injections in a Randomized Clinical Trial

Carlo Doria
1   Department of Orthopedics, University of Sassari, Sassari, Italy
,
Giulia Raffaella Mosele
1   Department of Orthopedics, University of Sassari, Sassari, Italy
,
Gianfilippo Caggiari
1   Department of Orthopedics, University of Sassari, Sassari, Italy
,
Leonardo Puddu
1   Department of Orthopedics, University of Sassari, Sassari, Italy
,
Emanuele Ciurlia
1   Department of Orthopedics, University of Sassari, Sassari, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
11. August 2017 (online)

   Lizenzen und Reprints

Abstract

Purpose The aim of this study was to compare the clinical efficacy of ultrasound-guided intra-articular injections of autologous platelet rich plasma (PRP) versus hyaluronic acid (HA) for symptomatic early osteoarthritis (OA) of the hip.

Methods A prospective controlled double-blinded randomized trial on 80 patients with hip OA was conducted. The patients were divided in two groups of 40 patients each: group 1 underwent three PRP intra-articular ultrasound-guided injections, whereas group 2 underwent three HA injections. WOMAC, VAS, and Harris Hip Score were evaluated for both groups before and at 6 and 12 months after treatment.

Results The two groups were comparable in age, sex, body mass index, and severity of hip OA. Both groups showed a significant improvement from baseline at 6-month and 12-month follow-ups for all the outcome measures. No major complications were observed during the treatment and at follow-ups in both the groups.

Conclusion PRP did not offer significantly better results compared with HA in patients with moderate signs of OA, and thus it should not be considered as first-line treatment.

Level of Evidence Level II, randomized controlled trial.

Keywords

hip - osteoarthritis - hyaluronic acid - platelet rich plasma - ultrasound - injection
 

  • References

  • 1 Robinson P, Keenan AM, Conaghan PG. Clinical effectiveness and dose response of image-guided intra-articular corticosteroid injection for hip osteoarthritis. Rheumatology (Oxford) 2007; 46 (02) 285-291
    PubMedSuche in Google Scholar
  • 2 Abate M, Pelotti P, De Amicis D, Di Iorio A, Galletti S, Salini V. Viscosupplementation with hyaluronic acid in hip osteoarthritis (a review). Ups J Med Sci 2008; 113 (03) 261-277
    CrossrefPubMedSuche in Google Scholar
  • 3 Richette P, Ravaud P, Conrozier T. , et al. Effect of hyaluronic acid in symptomatic hip osteoarthritis: a multicenter, randomized, placebo-controlled trial. Arthritis Rheum 2009; 60 (03) 824-830
    CrossrefPubMedSuche in Google Scholar
  • 4 Battaglia M, Guaraldi F, Vannini F. , et al. Platelet-rich plasma (PRP) intra-articular ultrasound-guided injections as a possible treatment for hip osteoarthritis: a pilot study. Clin Exp Rheumatol 2011; 29 (04) 754
    PubMedSuche in Google Scholar
  • 5 Sánchez M, Guadilla J, Fiz N, Andia I. Ultrasound-guided platelet-rich plasma injections for the treatment of osteoarthritis of the hip. Rheumatology (Oxford) 2012; 51 (01) 144-150
    CrossrefPubMedSuche in Google Scholar
  • 6 Battaglia M, Guaraldi F, Vannini F. , et al. Efficacy of ultrasound-guided intra-articular injections of platelet-rich plasma versus hyaluronic acid for hip osteoarthritis. Orthopedics 2013; 36 (12) e1501-e1508
    CrossrefPubMedSuche in Google Scholar
  • 7 Di Sante L, Villani C, Santilli V. , et al. Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis. Med Ultrason 2016; 18 (04) 463-468
    CrossrefPubMedSuche in Google Scholar
  • 8 Bennell KL, Hunter DJ, Paterson KL. Platelet-rich plasma for the management of hip and knee osteoarthritis. Curr Rheumatol Rep 2017; 19 (05) 24
    CrossrefPubMedSuche in Google Scholar
  • 9 Meloni F, Milia F, Cavazzuti M. , et al. Clinical evaluation of sodium hyaluronate in the treatment of patients with sopraspinatus tendinosis under echographic guide: experimental study of periarticular injections. Eur J Radiol 2008; 68 (01) 170-173
    CrossrefPubMedSuche in Google Scholar
  • 10 Atchia I, Kane D, Reed MR, Isaacs JD, Birrell F. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis. Ann Rheum Dis 2011; 70 (01) 110-116
    CrossrefPubMedSuche in Google Scholar
  • 11 Mei-Dan O, McConkey MO, Petersen B, McCarty E, Moreira B, Young DA. The anterior approach for a non-image-guided intra-articular hip injection. Arthroscopy 2013; 29 (06) 1025-1033
    CrossrefPubMedSuche in Google Scholar
  • 12 Salaffi F, Leardini G, Canesi B. , et al; GOnorthrosis and Quality Of Life Assessment (GOQOLA). Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage 2003; 11 (08) 551-560
    CrossrefPubMedSuche in Google Scholar
  • 13 Dettoni F, Pellegrino P, La Russa MR. , et al. Validation and cross cultural adaptation of the Italian version of the Harris Hip Score. Hip Int 2015; 25 (01) 91-97
    CrossrefPubMedSuche in Google Scholar
  • 14 Migliore A, Procopio S. Effectiveness and utility of hyaluronic acid in osteoarthritis. Clin Cases Miner Bone Metab 2015; 12 (01) 31-33
    PubMedSuche in Google Scholar
  • 15 Anitua E, Sánchez M, Nurden AT. , et al. Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford) 2007; 46 (12) 1769-1772
    CrossrefPubMedSuche in Google Scholar
  • 16 Caggiari G, Mosele GR, Puddu L, Doria C. Efficacy of platelet-rich plasma in experimental instrumented interbody spinal fusion. EuroMediterranean Biomed J 2016; 11 (10) 141-147
    PubMedSuche in Google Scholar
  • 17 Anitua E, Sánchez M, Zalduendo MM. , et al. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif 2009; 42 (02) 162-170
    CrossrefPubMedSuche in Google Scholar
  • 18 Kon E, Buda R, Filardo G. , et al. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 2010; 18 (04) 472-479
    CrossrefPubMedSuche in Google Scholar
  • 19 Filardo G, Kon E, Buda R. , et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2011; 19 (04) 528-535
    CrossrefPubMedSuche in Google Scholar
  • 20 Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 2010; 38 (02) 255-262
    CrossrefPubMedSuche in Google Scholar
  • 21 Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 2011; 39 (06) 1200-1208
    CrossrefPubMedSuche in Google Scholar
  • 22 de Vos RJ, Weir A, van Schie HTM. , et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 2010; 303 (02) 144-149
    CrossrefPubMedSuche in Google Scholar
  • 23 Mei-Dan O, Lippi G, Sánchez M, Andia I, Maffulli N. Autologous platelet-rich plasma: a revolution in soft tissue sports injury management?. Phys Sportsmed 2010; 38 (04) 127-135
    CrossrefPubMedSuche in Google Scholar