Ultrasound-Guided Hip Platelet-Rich Plasma Injection in the Sports Medicine Clinic- SOMOS 2025

r robins, m defoor, m mcdermott s davidson, t dekker

Abstracted accepted for a rapid-fire presentation at the 2025 Society of Military Orthopaedic Surgeons Annual Meeting.

INTRODUCTION: Chronic hip pain is a growing concern in active populations, often resulting from femoroacetabular impingement (FAI), labral pathology, or early degenerative changes. These conditions can significantly impair mobility, physical performance, and readiness. While conservative therapies remain first-line, biologic treatments such as leukocyte-poor platelet-rich plasma (LP-PRP) have emerged as potential adjuncts for managing chronic intra-articular hip pathology. LP-PRP may offer anti-inflammatory and regenerative benefits with a favorable safety profile. Despite increasing interest, evidence supporting the use of serial LP-PRP injections for hip pathology in active patient populations remains limited. This case series investigates the effectiveness of a standardized three-injection protocol of ultrasound-guided LP-PRP injections administered to patients with chronic hip pain in a military sports medicine clinic, monitored over 12 months evaluating changes in pain, function, and readiness status for active-duty members.

METHODS: Fifty-five patients underwent a series of 3 injections of LP-PRP (Arthrex ACP) over a period of 3 weeks.  All patients utilized the Military Orthopaedic Tracking Injuries and Outcomes Network (MOTION) patient reported outcomes (PROs) database to record their response to treatment prior to injection, 6 weeks, 12 weeks, 6 months, and 1 year following injection. Functional outcomes were measured with IHOT-12, HOS-ADL, SANE, and PROMIS Physical Function (PF).  Pain was evaluated with DVPRS and PROMIS Pain Interference (PI). A MOTION readiness questionnaire was used to determine readiness to deploy among active-duty servicemembers.  Numeric variables for each PRO were expressed as mean (±SD) and discrete outcomes as absolute and relative (%) frequencies. Normality and heteroskedasticity of continuous data were assessed with Shapiro-Wilk and Levene’s test respectively. Continuous outcomes were compared with Anova, Welch Anova or Kruskal-Wallis tests according to data distribution. Discrete outcomes were compared with chi-squared or Fisher’s exact test accordingly. The alpha risk was set to 5% and two-tailed tests were used.  Finally, univariate analysis utilizing the Kruskal test allowed for comparison of survey score medians across collected survey time points. The alpha risk was set to 0.05.  Statistical analysis was performed with EasyMedStat (version 3.42).

RESULTS: While IHOT-12 and SANE did not demonstrate an association of higher scores except for a trend at 12 weeks (IHOT-12: β=12.4, [-0.65 ; 25.44], p= 0.0624; SANE: β=11.19, [-1.54 ; 23.92], p= 0.0843), HOS-ADL demonstrated an associated trend towards improved function at 1 year (β=11.37, [-0.62 ; 23.35], p= 0.0628).  PROMIS PF demonstrated no association with improved scores over 12 months (β=0.47, [-3.8 ; 4.74], p= 0.8256).  For pain outcomes, DVPRS demonstrated a trend towards improved pain at 12 weeks (β=-1.0, [-2.07 ; 0.07], p= 0.0658), and PROMIS PI demonstrated no association with improvement in scores over time through 12 months (β=-3.33, [-7.57 ; 0.91], p= 0.121).  Finally, MOTION readiness scores, completed in 7 of 18 active-duty service members, improved from 41.07 (CI±33.62) prior to treatment to 63.33 (CI±32.34) at 12 months, but multivariate analysis was not possible due to a low number of patients completing the MOTION Readiness survey.    

DISCUSSION/CONCLUSION: Results from this study demonstrate mixed results regarding function and pain in patients undergoing a series of 3 ultrasound-guided LP-PRP injections for chronic hip pain in a sports medicine clinic.  These findings suggest there may be improved function at 12 weeks with possible improvement in activities of daily living at 12 months.  This study also suggests improved pain at 12 weeks following treatment.  Finally, a series of LP-PRP injections may help improve readiness status for active-duty service members.  While this data suggests a series of 3 LP-PRP injections may improve pain and function for chronic pain in patients seen in a sports medicine clinic, further studies are warranted before ultrasound-guided LP-PRP injections are recommended for chronic hip pain in a sports medicine patient population.