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 recent 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, and is a widely used, effective treatment. 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 within the damaged area and since stem cells play a key role in repairing damaged tissue, anything which causes the stem cells to work harder promotes better healing. All PRP’s are not the same however. Regenexx SCP is a proprietary PRP formula containing 10-40 times the number of platelets of regular PRP. Because it’s processed in a specially equipped onsite lab by a skilled technician rather in a bedside centrifuge, in addition to the much greater concentration, parts of the blood that can cause inflammation and can inhibit optimum stem cell growth are removed, resulting in its significantly better treatment results.
The objective of this particular study was to evaluate the effects of placing PRP within the joints of patients undergoing arthroscopic surgery for femoroacetabular impingement (FAI), at the end of the surgery. 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 the patients received pre-surgical MRI’s. Joint effusion and labral integration was evaluated by MRI at 6 months and various 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 is beneficial, and that longer studies should be done to look at longer term results.
The upshot? The basis for Hip Impingement surgery has become controversial. Studies over the last few years have shown that the “pincer” is not caused by arthritis as previously thought, but is additional bone manufactured by the joint to regain its stability, thus protecting the joint and preventing further arthritis. Cutting things out that are there for a specific purpose doesn’t seem to make a whole lot of sense, but if you’re going to have Hip Impingement Surgery, a PRP shot seems to help!