Mario Hevesi1, George Jacob2, Kazunori Shimomura2, Wataru Ando3, Norimasa Nakamura4, Aaron J Krych5. 1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. 2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 3. Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan. 4. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan. 5. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. krych.aaron@mayo.edu.
Abstract
PURPOSE: The rapidly growing and emerging nature of biologics have made indications for regenerative and reparative hip therapies ever changing, with at times only early-stage evidence for their use. The purpose of this study was to review and summarize the currently available data on the management of hip cartilage injuries and osteoarthritis. METHODS: A scoping review of the available scientific literature for hip biologics was performed, with available evidence for hyaluronic acid (HA), platelet rich plasma (PRP), stem/stromal cells, microfracture, mosaicplasty, osteochondral allograft, and cell-based therapies investigated. RESULTS: To date, there exist better guidelines and further consensus concerning knee joint biologic treatments than the hip due to a greater number of studies as well as the more recent emergence of hip preservation approaches. However, increasing evidence is available for the selective implementation of biologics on an individualized basis with attention to lesion size and location. CONCLUSION: Orthopedic surgeons are at an exciting crossroads in medicine, where hip biologic therapies are evolving and increasingly available. Timetested interventions such as arthroplasty have shown good results and still have a major role to play but newer, regenerative approaches have the potential to effectively delay or reduce the requirement for such invasive procedures.
PURPOSE: The rapidly growing and emerging nature of biologics have made indications for regenerative and reparative hip therapies ever changing, with at times only early-stage evidence for their use. The purpose of this study was to review and summarize the currently available data on the management of hip cartilage injuries and osteoarthritis. METHODS: A scoping review of the available scientific literature for hip biologics was performed, with available evidence for hyaluronic acid (HA), platelet rich plasma (PRP), stem/stromal cells, microfracture, mosaicplasty, osteochondral allograft, and cell-based therapies investigated. RESULTS: To date, there exist better guidelines and further consensus concerning knee joint biologic treatments than the hip due to a greater number of studies as well as the more recent emergence of hip preservation approaches. However, increasing evidence is available for the selective implementation of biologics on an individualized basis with attention to lesion size and location. CONCLUSION: Orthopedic surgeons are at an exciting crossroads in medicine, where hip biologic therapies are evolving and increasingly available. Timetested interventions such as arthroplasty have shown good results and still have a major role to play but newer, regenerative approaches have the potential to effectively delay or reduce the requirement for such invasive procedures.
Authors: Mario Hevesi; David E Hartigan; Isabella T Wu; Bruce A Levy; Benjamin G Domb; Aaron J Krych Journal: Am J Sports Med Date: 2018-05-03 Impact factor: 6.202
Authors: Marco Marcarelli; Marcello Zappia; Lorenzo Rissolio; Chiara Baroni; Carlo Astarita; Letizia Trovato; Antonio Graziano Journal: J Clin Med Date: 2021-01-17 Impact factor: 4.241