Platelet-Rich Plasma Augmentation of Arthroscopic Hip Surgery for Femoroacetabular Impingement: A Prospective Study With 24-Month Follow-up

Arthroscopy. 2015 Oct;31(10):1886-92. doi: 10.1016/j.arthro.2015.03.025. Epub 2015 May 15.

Abstract

Purpose: The objective of this study is to evaluate the clinical and immunologic effects of intra-articular doses of platelet-rich plasma (PRP) in arthroscopic hip surgery for femoroacetabular impingement.

Methods: Preoperatively, patients were randomized either to receive an intra-articular injection of PRP (group I, n = 30) or not to receive PRP (group II, n = 27) at the end of hip arthroscopic surgery. To evaluate the clinical outcome and follow-up, we used the modified Harris Hip Score (mHHS) 3, 6, and 24 months after surgery. Pain was evaluated using a visual analog scale 24 hours, 48 hours, 3 months, and 6 months after surgery. The radiologic outcome was analyzed using radiographs and magnetic resonance imaging (MRI) obtained before surgery and 6 months after surgery. Labral integration and joint effusion were evaluated with MRI at 6 months. For statistical analysis, an independent t test and the Wilcoxon rank sum test were used (P < .05 was considered statistically significant).

Results: The visual analog scale score 48 hours after surgery was 3.04 in group I compared with 5.28 in group II (P < .05). At the 3-month follow-up, the mHHS was 91.79 in group I versus 90.97 in group II (P = .65). At the 24-month follow-up, the mHHS was 93.41 in group I (P = .56) versus 92.32 in group II (P = .52). At the 6-month follow-up, MRI showed no effusion in 36.7% of patients in group I versus 21.1% of patients in group II (P = .013). Regarding labral integration, no statistical differences were observed between the groups (P = .76).

Conclusions: In this randomized study, PRP resulted in lower postoperative pain scores at 48 hours and fewer joint effusions at 6 months. These findings suggest that PRP may have a benefit regarding postoperative inflammation; however, the long-term clinical benefit is unclear.

Level of evidence: Level II, lesser-quality randomized controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arthroscopy / methods*
  • Female
  • Femoracetabular Impingement / surgery*
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Platelet-Rich Plasma*
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult