A review of the efficacy of intraarticular hip injection for patients with hip osteoarthritis: To inject or not to inject in hip osteoarthritis?
Sanjiv Rampal1
, Ashish Jaiman2, Mehmet Ali Tokgöz3, Gayathri Arumugam4, Sureshan Sivananthan5, Rashdeep Singh Jagdeb Singh6, Syafiqah Binti Zazali1, Maziar Mohaddes7,8
1Department of Orthopaedics, Faculty of Medical and Health Sciences, University Putra Malaysia, Serdang, Malaysia
2Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
3Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Turkey
4Department of Orthopaedics, Hospital Port Dickson, Negeri Sembilan, Malaysia
5Department of Orthopaedics, Alty Orthopaedic Hospital, Kuala Lumpur, Malaysia
6Department of Orthopaedics, Miri General Hospital, Miri, Malaysia
7Department of Orthopaedics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
8Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
Keywords: Bone marrow aspirate concentrate, corticosteroids, hip injection, hip osteoarthritis, hyaluronic acid, mesenchymal stem cell, platelet-rich plasma, steroid.
Abstract
Hip injection (HI) for osteoarthritis (OA) are in vogue nowadays. Corticosteroids (CSs) and hyaluronic acid (HA) gel are the two most common agents injected into the hip. Off late, platelet-rich plasma (PRP), mesenchymal stem cell (MSC), bone marrow aspirate concentrate (BMAC), local anesthetic (LA) agents, non-steroidal anti-inflammatory drugs (NSAIDs) and their different combinations have also been injected in hips to provide desired pain relief. However, there is a group of clinicians who vary of these injections. A search of the literature was performed on PubMed, Cochrane Library, and DOAJ using the keywords “hip osteoarthritis injection”. Data were analyzed and compiled. Intraarticular CSs are effective in providing the desired pain relief in OA hip, but repeated injections should be avoided and the interval between HI and hip arthroplasty must be kept for more than three months. Methylprednisolone or triamcinolone are combined with 1% lidocaine or 0.5% bupivacaine. Chondrotoxic effects of LA is a concern. Although national guidelines do not favor the use of HA for hip OA, numerous publications have favored its usage for a moderate grade of OA. The PRP, MSC, and BMAC are treatment options with great potential; however, currently, the evidence is conflicting on their role in hip OA. There is always a risk of septic arthritis, particularly when aseptic precautions are not followed, and clinicians must vary of this complication.
Citation: Rampal S, Jaiman A, Tokgöz MA, Arumugam G, Sivananthan S, Jagdeb Singh RS, et al. A review of the efficacy of intraarticular hip injection for patients with hip osteoarthritis: To inject or not to inject in hip osteoarthritis?. Jt Dis Relat Surg 2022;33(1):255-262.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.