Surgery for Hip Impingement, or FAI, is incredibly common. All surgery creates a huge demand in the surgical area for healing. What if a known healing stimulator like PRP was added at the end of the surgery? A new study attempts to answer whether or not PRP improves hip arthroscopy outcomes.
PRP, or Platelet Rich Plasma, is made by extracting and concentrating the platelets in a patient’s blood. This is beneficial because platelets contain healing growth components that increase the body’s natural ability to repair itself. The platelets have a stimulating effect on the stem cells in the damaged area and since stem cells play a key role in repairing damaged tissue, the platelets jump start the stem cells to work harder, stimulating the healing process. PRP is a widely accepted, effective treatment, but not all PRP is the same. Regenexx SCP is different than standard PRP as it is a much purer and more concentrated proprietary formula, providing 10-40 times the amount of platelets as ordinary PRP. It is also processed in an onsite lab rather than in a bedside centrifuge, allowing us to eliminate components which can inhibit the stimulation of the stem cells and cause inflammation.
The objective of this particular study was to evaluate the clinical and immunologic effects of placing PRP within the joints of patients undergoing arthroscopic surgery for femoroacetabular impingement. (FAI). To do this they randomized 57 patients to either receive PRP or not, which resulted in 30 patients receiving PRP, and 27 patients not receiving PRP. All of patients had pre-surgical MRI’s. Joint effusion and labral integration was evaluated by MRI at 6 months various and metrics were used to evaluate pain and surgical outcomes at 24 hours, 48 hours, 3 months and 6 months after surgery. The conclusions of the study were that PRP resulted in lower postoperative pain scores at 48 hours and fewer joint effusions at 6 months, suggesting that PRP may be beneficial regarding postoperative inflammation, and, longer studies should be done to look at longer term results.
The upshot? Hip Impingement surgery in of itself is controversial, and trying biologics like PRP or stem cells before surgery is even considered would be a much less invasive option. This is especially true because studies over the last few years have shown that the “pincer” or bone spur manufactured by the joint is not caused by arthritis as previously thought, but specifically manufactured by the joint to regain stability, thus protecting it, and preventing further arthritis. Cutting things out that are there for a purpose doesn’t seem to make a whole lot of sense, and while I’m not a fan of hip arthroscopy, if you’re going to have Hip Impingement Surgery, a PRP shot seems to help!