EFFICACY OF PLATELET-RICH PLASMA INTRA-ARTICULAR INJECTION IN ADJUNCTION TO CONVENTIONAL THERAPY FOR ASEPTIC NECROSIS OF FEMORAL HEAD

Objectives: To evaluate the results of autologous platelet-rich plasma (PRP) intra-articular injection combined with medical therapy in treating aseptic necrosis of the femoral head (ANFH) after 5 months. Subjects and methods: Non-control interventional study, comparing before and after treatment for 30 patients (47 sterile necrotic femoral heads) who received 2 injections of PRP one month apart. Evaluation of clinical symptoms and images of necrosis on magnetic resonance imaging of the hip joint after 5 months. Results: The mean Visual Analogue Scale (VAS) decreased from 7.03 ± 1.90 to 3.77 ± 2.64, and the rate of severe pain decreased from 63.3% to 23.3%. The average range of motion of the hip joint increased (flexion from 87.17 ± 13.69 to 101.50 ± 14.69; abduction from 21.50 ± 5.89 to 28.50 ± 7.09; external rotation from 28.33 ± 4.01 to 34.00 ± 5.15; internal rotation from 30.33 ± 4.90 to 34.17 ± 4.93 degrees) with p < 0.001. According to Merle D'Aubigné, the ability to walk score increased from 4.05 ± 0.83 to 4.95 ± 0.76 (p < 0.001). Magnetic resonance imaging showed the rate of bone marrow edema decreased from 66.7% to 40.0% (p < 0.05), four sterile necrotic femoral heads from stage III to stage IV. Conclusion: The results of autologous PRP intra-articular injection combined with medical therapy in treating ANFH have markedly improved analgesia and motor function.