Efficacy of platelet-rich plasma versus placebo for the treatment of greater trochanteric pain syndrome: A double-blinded randomized controlled trial
Atchia, Ismael Ali, Mohammed Oderuth, Eshan Holleyman, Richard Malviya, Ajay
Atchia, Ismael
Ali, Mohammed
Oderuth, Eshan
Holleyman, Richard
Malviya, Ajay
Abstract
BACKGROUND: Greater trochanteric pain syndrome (GTPS) is a painful condition that can impair a patient's quality of life. If nonoperative measures fail, progressively more invasive treatment options may be required. This clinical trial aimed to evaluate the effectiveness of ultrasound-guided leukocyte-rich platelet-rich plasma (LR-PRP) injections in the treatment of refractory GTPS caused by bursitis and/or gluteal tendinopathy.
METHODS: An ethically approved, adequately powered, double-blinded randomized controlled trial (RCT) was conducted to evaluate the clinical outcomes in randomized LR-PRP and placebo groups using the International Hip Outcome Tool-12 (iHOT-12), a visual analogue scale (VAS) for pain, the modified Harris hip score (mHHS), the EuroQol 5-Dimensions (EQ-5D) questionnaire, and the presence or absence of complications. All injections were performed under ultrasound guidance into the trochanteric bursa and gluteus medius tendon.
RESULTS: The final analysis included 79 patients (39 in the LR-PRP and 40 in the placebo group; 73 female and 6 male; all Caucasian). Both the LR-PRP and the placebo group generally had improvement from baseline that was maintained to 12 months. The only deterioration in scores compared to baseline was seen in the LR-PRP group for the iHOT-12 at 12 months, the EQ-5D index at 3 and 6 months, and the EQ-5D VAS at all follow-up time points. However, there was no significant difference between the 2 groups at any follow-up point (p > 0.05). A multivariable linear regression model, with adjustment for age, sex, body mass index, and preoperative baseline score, did not reveal any significant associations between iHOT-12 and EQ-5D score gains at 12 months and treatment.
CONCLUSIONS: This randomized trial found no significant difference in outcomes between LR-PRP and placebo for the treatment of greater trochanteric pain up to 6 months following the intervention. As a result, we do not support the routine use of PRP for the treatment of this condition.
LEVEL OF EVIDENCE: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.
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Date
2025-01-13
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Article
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Citation
Atchia, I., Ali, M., Oderuth, E., Holleyman, R. and Malviya, A. (2025) 'Efficacy of platelet-rich plasma versus placebo for the treatment of greater trochanteric pain syndrome: A double-blinded randomized controlled trial', Journal of Bone and Joint Surgery, 107(5), pp. 444–451. doi: 10.2106/JBJS.24.00763 https://doi.org/10.2106/jbjs.24.00763.