Biologic Options for the Hip: How PRP Supports Joint Preservation

Hip pain and degeneration can severely limit mobility and quality of life, especially as we age or sustain injuries. Innovative biologic treatments, like platelet-rich plasma (PRP) injections, offer a natural way to promote healing and preserve joint function without surgery. Here’s how PRP supports joint preservation in the hip and why it’s gaining popularity.

Understanding Hip Osteoarthritis and the Need for Joint Preservation

Hip osteoarthritis (OA) involves the gradual breakdown of cartilage cushioning the joint, leading to pain, stiffness, and reduced function. Traditional treatments often focus on managing symptoms or require invasive surgery. PRP offers an alternative by potentially slowing degeneration and promoting joint health, particularly in patients with early to moderate OA.

How PRP Enhances Healing in the Hip Joint

PRP enhances healing in the hip joint by activating multiple cellular and molecular pathways that facilitate both tissue repair and inflammation control.

Stimulates Tissue Repair:

• PRP is rich in growth factors, including PDGF, TGF-β, IGF, FGF, VEGF, and HGF. When injected into the hip joint, these growth factors are released from platelets and may help to stimulate cellular processes essential for repair.
• PDGF, FGF, and IGF encourage the proliferation and differentiation of mesenchymal cells and chondrocytes (cartilage cells), promoting collagen and proteoglycan synthesis, key elements for cartilage and soft tissue regeneration.
• VEGF and HGF help in angiogenesis (formation of new blood vessels), improving blood supply and nutrient delivery to damaged tissues, which is critical for repair.
• PRP may also accelerate the healing of tendons and ligaments by promoting fibroblast activity and extracellular matrix production.

Reduces inflammation:

• PRP can help to reduce inflammation by modulating the activity of inflammatory cells and cytokines at the injury site.
• Growth factors in PRP can interfere with the NFκB signaling pathway, a major driver of joint inflammation. PRP may inhibit the production of proinflammatory cytokines (such as IL-1β, TNF-α) and destructive enzymes (MMPs), lowering inflammatory damage to joint tissues and creating a more favorable environment for healing.

This anti-inflammatory action not only reduces pain but also protects cells from further degenerative changes, leading to sustained improvements in joint function.

Evidence Supporting PRP for Hip Joint Health

Clinical studies show PRP injections reduce pain and improve function in patients with hip OA, with benefits noticeable as early as 1-2 months and persisting up to 12 months post-injection.

Advantages of PRP Over Traditional Treatments

• Minimally Invasive: PRP is injected with no surgery or incisions involved, making it a lower-risk option.
• Autologous Treatment: Using the patient’s own blood minimizes the risk of allergic reactions or infection.
• Cost-Effective Alternative: PRP may help delay or reduce the need for expensive joint replacement surgeries.
• Quick Procedure and Recovery: The process usually takes under 90 minutes, with minimal downtime afterward.

Who Can Benefit Most from PRP Therapy for the Hip?

Patients with early to moderate hip osteoarthritis, hip bursitis, or soft tissue injuries around the hip often respond well to PRP therapy. It is particularly suited for those looking to avoid or postpone surgery, maintain an active lifestyle, and harness their body’s natural healing potential.

The Future of Hip Joint Preservation with Biologics

As research continues to evolve, PRP and other orthobiologic treatments are becoming integral to hip joint preservation strategies. They emphasize repair rather than replacement, offering a promising path for patients seeking less invasive solutions with lasting benefits.

AUTHOR: Mark F. Schinsky, MD, is a board-certified, fellowship-trained orthopedic surgeon specializing in adult reconstructive surgery, with a focus on hip and knee replacement. He has extensive expertise in minimally invasive techniques, complex primary procedures, and revision total joint replacements, using the latest surgical technologies and biologics to improve outcomes and recovery.

Reference:
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC10353029/