Are platelet-rich plasma injections effective in adults with degenerative joint disease of the hip?
The data on the effectiveness of PRP injections in adults with hip DJD are limited to a few small studies of low to moderate quality, likely resulting in overinflated estimates of benefit.
Plan de l'etude:
These authors searched several databases, conducted manual searches of the bibliographies of included studies, and contacted authors of clinical trials and conference abstracts to identify studies that evaluated platelet-rich plasma (PRP) injections in treating adults with hip degenerative joint disease (DJD). They included 8 studies with 331 participants; 5 were randomized trials that compared PRP with hyaluronic acid. The overall quality of all studies was low to moderate, and the randomized trials, specifically, were poor to middling in quality. The authors report slight differences in the preparation of the PRP, the dosing frequency and interval, as well as the use of leukocyte-rich versus leukocyte-poor PRP. Additionally, the follow-up ranged from 4 months to 14 months. Despite all this variability, the authors chose to pool the data. At least all the studies used the same 10-cm visual analog pain scale. The patients receiving PRP injections had a greater degree of improvement than the control patients (net difference 1.6/10); not surprisingly, though, these data were markedly heterogeneous (I2 = 75.8%). This difference is right at the minimum clinically important difference. Overall, at the conclusion of each study, there was no significant difference in function. Finally, 3 of the studies reported that adverse events were infrequent, mild, and transient.
Henry C. Barry, MD, MS
Michigan State University
East Lansing, MI