Osteoarthritis of the hip is a painful degenerative disease that can have a huge impact on mobility and quality of life. In the later stages, joint replacement surgery is normally the only effective treatment, helping to relieve pain and restore function.
However, someone with mild to moderate osteoarthritis may be offered a range of different treatments to help them manage symptoms and slow the progression of the disease. Intra-articular injections (injections directly into the joint space) are often used to provide pain relief and functional improvements, as part of a staged approach.
Intra-articular injections for arthritis
Commonly used are:
- Steroid injections which can reduce inflammation and, therefore, help to relieve pain. Some work within hours and the effects last around a week, while others take a week or so to become effective but then continue to work for several months.
- Hyaluronic acid injections are used to improve mobility in the affected joint and relieve pain, particularly when other treatments haven’t worked. Hyaluronic acid is naturally found in the synovial fluid within the joints of your body where it helps to lubricate and keep the joint moving smoothly. Injections of hyaluronic acid are given to help lubricate joints where the cartilage has been damaged by osteoarthritis.
- Platelet rich plasma injections use platelets extracted from the patient’s own blood. These contain growth factors – a type of protein that has healing properties. A PRP injection contains between five and 10 times the amount of platelets as a normal blood sample, which are injected into a damaged joint to ease pain and support healing. A PRP treatment takes around an hour and the effects can last up to six months or longer.
- Local anaesthetic joint injections are used to relieve pain in the short-term. They combine local anaesthetic with a small dose of steroid, which is injected into the painful joint. Pain relief can last from a few days up to several months.
A study into the effectiveness of intra-articular injections
A group of researchers from Xinjiang Medical University, First Affiliated Hospital in Urumqi and Xiangya Hospital in Changsha set out to compare the effectiveness of the different intra-articular injections used in the management of hip osteoarthritis, with a follow-up of up to six months after treatment.
They carried out a systematic review and network meta-analysis, using a Bayesian random-effects model to compare the different treatment options. Following a review of randomised controlled trials published across key industry journals, the research team completed a detailed meta-analysis of 16 randomised controlled trials, involving 1,735 participants.
They found that patients receiving an intra-articular injection of steroids showed better pain relief and improved hip joint function within three months compared to the other six treatments. However, there was no significant difference observed at six months. Steroid injections were shown to be considerably more effective than a placebo injection for improving hip function at three months. However, by six months, the combination of hyaluronic acid and platelet-rich plasma proved to be substantially more effective. The study was published in The Bone and Joint Journal 2024: 106-B(6):532-539.
If you are interested in discussing the range of different injections for managing symptoms of hip osteoarthritis, contact us. We can explain the pros and cons of each approach and create a tailored treatment plan for you. If you have more advanced osteoarthritis, we are happy to explain what is entailed in undergoing hip replacement surgery.
