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The Heidari Publications
94 publications · 23 years of research · click or drag a page corner to turn
Royal College
British Orthopaedic
AO Trauma
Churchill
Limb Recon
Specialist Reg.
Heidari N, Slevin M, Zeinolabediny Y, Meloni D, Olgiati S, Wilson A, et al..
Hip osteoarthritis (OA) is a major contributor to reduced quality of life and concomitant disability associated with lost working life months. Intra-articular injection of various biological materials has shown promise in alleviating symptoms and potentially slowing down the degenerative process. Here, we compared the effects of treatment of a cohort of 147 patients suffering from grade 1-4 hip OA; with either micro-fragmented adipose tissue (MFAT), or a combination of MFAT with platelet-rich plasma (PRP). We found significant improvements in both the visual analogue score for pain (VAS) and Oxford hip score (OHS) that were similar for both treatments with over 60% having an improvement in the VAS score of 20 points or more. These results suggest a positive role for intra-articular injection of MFAT + PRP as a treatment for hip osteoarthritis which may be important particularly in low body mass index (BMI) patients where the difficulty in obtaining sufficient MFAT for treatment could be offset by using this combination of biologicals.
What did we look at?
Whether two injection treatments for painful hip arthritis — an injection of micro-fragmented adipose tissue (MFAT, a small amount of the patient’s own fat) on its own, or MFAT mixed with platelet-rich plasma (PRP, a concentrate from the patient’s own blood) — produced different results at one year.
Why did we look at it?
Hip osteoarthritis is a major cause of pain, lost mobility, and time off work. Some patients are not yet ready for hip replacement, or want to delay it. Biological injections are emerging as a way to ease pain and possibly slow the wear of the joint, but it is not yet clear which preparation works best.
What did we find?
147 patients with hip arthritis (grades 1 to 4) had one of the two injections and were followed for a year. Both groups showed meaningful improvements in pain and in function. More than 60% of patients reported a 20-point or greater drop in their pain score — a clinically important change. The results were broadly similar between the two treatments, although adding PRP may help in patients with a low body mass index, where it can be hard to harvest enough fat for an MFAT-only injection.
What does this mean for patients?
For people with hip arthritis who are not yet at the point of joint replacement, this study suggests that an MFAT injection — with or without PRP — may meaningfully reduce pain and improve function for at least a year. The study cannot tell us whether the effect lasts longer, or how it compares to surgery; further research is needed.
Journal of Clinical Medicine 2022;11(4). doi:10.3390/jcm11041056