Marc Darrow, MD, JD.

A January 2021 paper (1) examined the application of biologics (injections made from cells) during arthroscopic FAI surgery. In reviewing past research the study authors wrote: “An randomized control trial examined the effects of intra-articular injection of PRP during hip arthroscopy with indication of Femoroacetabular Impingement. (A group of  patients) treated with PRP intraoperatively reported lower pain scores 48 hours post-operatively and demonstrated fewer joint effusions at six-month follow-up. The study supported the use of intraoperative PRP intra-articular injections to reduce inflammation following hip arthroscopy but concluded more research should be conducted to determine long-term benefits. Similarly, another randomized control trial demonstrated decreased inflammation and ecchymosis (skin discoloration) following hip arthroscopy with intra-articular PRP injections. Despite immediate post-operative benefits, the study concluded that PRP injections did not produce significant improvements in outcomes at 1-year follow-up when comparing 20 patients who received PRP to 15 control patients without PRP intra-articular injections.

A November 2023 paper (2) reviewed the case histories of 345 patients who were recruited into their study to assess whether PRP injections into the hip capsule during arthroscopic surgery for Femoroacetabular Impingement Syndrome provided the patients with any recovery benefits. The 345 patients were divided into two groups. The great majority, 293 patients were in the group that had the during surgery PRP injection. The other 52 did not have the PRP. The results revealed “The data from this study suggest that there is no difference in outcomes with PRP injection onto the capsule after capsular closure during hip arthroscopy, despite PRP having been shown to have beneficial effects in other applications within orthopaedics. The lack of effect of the PRP in these patients may have been the result of many factors, including anti-inflammatory medications taken during the postoperative period as part of multimodal pain control, dilution of the PRP within residual arthroscopic irrigation fluid, or no true effect of capsular healing by the PRP.”

An October 2023 paper (3) reviewed 440 patient outcomes from eleven studies following PRP, hyaluronic acid, or cell based treatments during or soon after their femoroacetabular impingement syndrome surgery. The paper’s authors wrote that  all 11 studies showed improvements in patient reported outcomes from baseline to most-recent follow-up. In four studies, PRP injections were given either intraoperatively or the day after surgery as a secondary treatment for labral repair.

Cell based therapies was used intraoperatively in acetabular chondral lesion repair (three studies) and labral repair (one study). When compared to a control group at most recent follow-up, three PRP groups demonstrated similar patient reported outcomes, while one PRP group exhibited worse visual analog pain scores. The four cell based therapies studies reported favorable results compared to a control group.

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References

1 Sullivan SW, Aladesuru OM, Ranawat AS, Nwachukwu BU. The use of biologics to improve patient-reported outcomes in hip preservation. Journal of Hip Preservation Surgery. 2021 Jan;8(1):3-13.
12 Morris SC, Haselman WT, Banffy MB. Patient Outcomes Are Not Improved by Platelet-Rich Plasma Injection Onto the Capsule at the Time of Closure During Hip Arthroscopy for Femoroacetabular Impingement Syndrome. Arthroscopy, Sports Medicine, and Rehabilitation. 2023 Dec 1;5(6):100816.
13 George T, Curley AJ, Saeed SK, Kuhns BD, Parsa A, Domb BG. Orthobiologics as an adjunct in treatment of femoroacetabular impingement syndrome: cell-based therapies facilitate improved postoperative outcomes in the setting of acetabular chondral lesions—a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy. 2023 Oct 31:1-9.