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Therapeutic Injections for Arthritic Hip Pain and Function

Intra-articular hip injections are a common approach for treating pain and disability related to hip osteoarthritis. They are typically offered only if conservative treatment such as oral medications, manual therapy and exercise have been ineffective.


A number of different injections are currently offered in Canada including corticosteroids, hyaluronic acid (HA), and platelet rich plasma (PRP). Both the costs and effectiveness of injections should be considered when deciding whether to pursue injections as a treatment option.


A recent high-quality review by Gazendam et al, 2020(1) investigated the effectiveness of corticosteroids, PRP and HA for improving pain and disability associated with mild to moderate hip osteoarthritis. They found that all 3 injections were capable of producing a clinically meaningful reduction in pain and improvement in disability up to 6 months after the injection, with a trend for better pain improvements from steroids at 2-4 months, and disability improvements from steroids at 2-4 months and PRP at 6 months. However, they also found that saline placebo injections performed just as well as the other injections in both pain and disability scores.


These findings suggest that steroid, HA, PRP and placebo injections are effective in managing pain and improving disability due to hip osteoarthritis and all can be considered if other conservative treatment options have failed.


Summary:

  1. Current evidence suggests that steroid, hyaluronic acid and PRP hip injections are capable of improving pain and disability associated with hip osteoarthritis up to 6 months following the injections.

  2. Neither Steroids, hyaluronic acid or PRP injections are superior to placebo injections.

Author:

Dr. Corey Hofkirchner B.Sc (Hon) D.C.

Chiropractor, Medical acupuncture and ART provider

References:

1. Gazendam A, Ekhtiari S, Bozzo A, Phillips M, Bhandari M. Intra-articular saline injection as effective as rich plasma and hyaluronic acid for hip osteoarthritis pain: a systematic review and network meta-analysis of randomised controlled trials. Br J Sport Med. 2020;0:1–7.

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