PRP vs HA vs PRP+HA for Hip OA: US-Guided RCT
Dallari D · Am J Sports Med (2016)
DOI: 10.1177/0363546515620383This three-arm RCT compared ultrasound-guided PRP, HA, and a PRP+HA combination in 111 patients with hip OA. Notably, PRP alone was the most effective group, with the combination product performing worse than PRP alone. At 6 months, PRP demonstrated significantly lower VAS scores than both the combination and HA-only groups. The study also measured growth factor concentrations and correlated them with clinical outcomes.
Clinical Relevance
Suggests that mixing PRP with HA may dilute PRP's therapeutic effect rather than enhancing it. Clinicians considering hip OA injections should use PRP alone rather than combination products. This is one of the few clearly positive hip OA studies.
Key Takeaways
- PRP alone SUPERIOR to both HA and PRP+HA combination
- PRP VAS=21, PRP+HA=35, HA=44 at 6 months (PRP vs HA p<0.0005)
- Combination product was INFERIOR to PRP alone (counterintuitive finding)
- Growth factor concentrations correlated with clinical outcomes
- Ultrasound guidance used for all hip injections
- One of the most positive hip OA studies, contrasting later meta-analyses
Key Findings
PRP VAS=21 vs PRP+HA=35 vs HA=44 at 6mo. PRP vs HA p<0.0005. PRP ALONE superior to both HA and combination.
Clinical Context
Study Design
Randomized Controlled Trial
Condition
Hip Osteoarthritis
Sample Size
111 patients
Follow-up
12 months
Control Group
HA and PRP+HA combination
Primary Outcome
VAS, HHS, WOMAC
PRP Protocol & Intervention
Injection Frequency
3 injection(s)
Injection Interval
Weekly
Guidance Method
Ultrasound-guided