Intraosseous Infiltration of Platelet-Rich Plasma for Severe Hip Osteoarthritis

This work describes a technique of platelet-rich plasma (PRP) infiltration for the treatment of severe hip osteoarthritis (OA). Although the results achieved with intra-articular infiltrations of PRP are promising, they may be insufficient in the long-term for severe hip OA. The technique consists of a combined intra-articular and intraosseous infiltration of PRP to reach all joint tissues, especially the subchondral bone, and hence facilitate a greater distribution of PRP. Diagnosis is based on clinical and radiographic findings, and patients with grade III OA according to the Tönnis scale, as well as patients who have not responded to conventional treatment, are considered candidates for this technique. After an ultrasound-guided intra-articular PRP infiltration is performed, 2 intraosseous infiltrations are conducted with a fluoroscope; the first injection is applied into the acetabulum and the second into the femoral head. However, this technique presents more difficulty than the conventional administration, so it is necessary to consider several aspects described in this work.