There’s a new concept that gets introduced with regenerative medicine. That’s the idea that we can reduce degeneration in early arthritis or intervene early in tendon and ligament injuries. We’ve done that for our patients for many years, but we’re now beginning to see the research catch up. This morning I’ll review a new study on early hip arthritis and PRP.
As we age, we all want to remain as active as possible and avoiding big surgeries is one way to do that. However, most of the treatment used to manage arthritis is destructive toward the joint. For example, we now know through a large randomized controlled trial that injecting steroids into the knee joint can cause more loss of cartilage over time. However, with the advent of therapies that can ramp up the healing like PRP and/or stem cells, there’s an opportunity to use these treatments to intervene earlier.
If you want to understand more about this Proactive concept, my book on the subject is a quick read (click on the book cover):
If there was ever a type of arthritis where being proactive is critical, it would be hip arthritis. Hip arthritis is just a different animal than knee arthritis. Hips can go very quickly and advance from mild to severe arthritis within months to 1-2 years, whereas knees often smolder for years before making that type of jump in severity. In addition, once hips hit that severe arthritis level, the bone gets very involved and often begins to collapse. This means that even advanced stem cell treatments can struggle to reduce pain and increase function. Hence, hips are the perfect target for being proactive by using orthobiologics early.
New Research on Hip Arthritis and PRP
What is PRP? That stands for platelet-rich plasma. To learn more, see my video below:
The new study on patients with early hip arthritis was just presented at the Arthroscopy Association of North Ameria annual meeting (see page 21) . The researchers (Kraeutler) compared hyaluronic acid (a common injectable gel treatment for arthritis) against PRP in a randomized controlled trial. They found that the 32 patients who got PRP shots in their hips only went on to get a hip replacement at a rate of 11% compared to 50% for the 30 patients in the hyaluronic acid group (over 6 months). The PRP patients also had better functional scores and range of motion.
The upshot? We’ve been using PRP injections in early hip arthritis patients for years, hoping that this would buy them more time and reduce cartilage breakdown. This most recent research would support that this is possible. So as I say to all of my patients, it’s better to treat a small problem early than a big problem once it’s too late!
Reference: Kraeutler MJ, et al. A double-blind, randomized controlled trial comparing platelet-rich plasma vs. hyaluronic acid for early osteoarthritis of the hip joint. Presented at: Arthroscopy Association of North America Annual Meeting; May 2-4, 2019; Orlando.