HA-PRP Tube
Short Description:
PRP-HA KIT is a redefined innovation in aesthetic, gynecological and andrological medicine that combines two treatment concepts in one for natural results.
Osteoarthritis (OA) is one of the most significant disease burdens worldwide. The hip is the second most common location of OA behind the knee. Most hip OA is primary, although it can be associated with other pediatric diseases of the hip or certain risk factors such as increasing age, obesity and high impact sports. The vast majority of patients will report insidious onset of worsening hip pain without any clear injury. Diagnosis is easily made on radiographs.
CASE VIGNETTE
You are treating a 51 year old female athlete with mild hip osteoarthritis. She is inquiring about non-surgical options as she wants to continue running. Which of the following would not be considered first line therapy?
A) Physical Therapy
B) NSAIDS
C) Intra-articular injection
D) Proper footwear
The authors of this study performed a systematic review and meta-analysis of existing studies to compare these four treatment modalities (CS, HA, PRP, NS). Eligible studies must be randomised controlled trials assessing the efficacy of CS, HA, PRP and placebo (NS) for patients with hip OA. Ultimately, they included 11 RCTs comprising 1353 patients. Essentially, they concluded there was no difference between NS, CS, PRP and HA for hip OA at 2, 4 and 6 months. This was true for both low- and high molecular weight HA.
This study was a network meta-analysis that only included level 1 evidence which really helps the reader draw conclusions about comparative efficacy. They followed the Cochrane and PRISMA guidelines. Limitations include the (relatively) small sample size and that the authors did not compare IA injections to other modalities of nonoperative management. It also doesn’t appear to distinguish between the different stages of hip OA where management, including IA injections, can vary dramatically.
This is a strong study which provides level 5 evidence for management of hip OA. It doesn’t state that CS, PRP and HA don’t work, rather that there were no significant differences compared to NS at 2, 4 and 6 months. IA injections remain part of the multimodal management of non-surgical hip OA. There is probably some room for further investigation here as far as frequency of injections, combinations of injections and considering the effects of local anesthetics (which are also known to be chondrotoxic).
