Photoactivated Leucocyte-Rich Platelet-Rich Plasma Treatment in Reduction of Bone Marrow Edema in Hip Osteoarthritis

Abstract

Aim: To describe the successful treatment of bone marrow edema in the setting of hip osteoarthritis using ultrasound-guided injection of photoactivated leukocyte-rich platelet-rich plasma (LR-PRP). Setting: Outpatient clinic. Patient: 65-year old female with antalgic and listing gait. Case description: The patient presented with a 2-week history of left hip pain. Exam revealed restriction and pain at end range of motion. Imaging showed extensive bone marrow edema and hip effusion. The patient underwent four weekly photoactivated LR-PRP treatments. Results: The patient reported a significant reduction in pain with MRI showing an extensive resolution of bone marrow edema and complete pain relief at 2 and 6 months post-treatment, respectively. Conclusion: Photoactivated LR-PRP may be considered as a treatment option for patients with marrow edema in the setting of hip osteoarthritis.

summary

Aim: To describe the successful treatment of bone marrow swelling in the setting of hip osteoarthritis using ultrasound-guided injection of enhanced platelet-rich plasma (PRP). Setting: Outpatient clinic. Patient: 65-year old female with an abnormal gait. Case description: The patient presented with a 2-week history of left hip pain. Exam revealed restriction and pain at end range of motion. Imaging showed extensive bone marrow and hip swelling. The patient underwent four weekly enhanced PRP treatments. Results: The patient reported a significant reduction in pain with MRI showing an extensive resolution of bone marrow edema and complete pain relief at 2 and 6 months post-treatment, respectively. Conclusion: This specific enhanced PRP may be considered as a treatment option for patients with marrow edema in the setting of hip osteoarthritis.

Keywords::

• bone marrow edema
• bone marrow lesion
• cytokines
• growth factors
• hip pain
• LR-PRP
• platelet-rich plasma
• subchondral edema

Author contributions

Concept and design: Jeimylo C de Castro, Elvira L. Henares-Esguerra, Maria Bida Olivia S Tamayo-Shih

Acquisition, analysis or interpretation of data: Jeimylo C de Castro, Elvira L Henares-Esguerra, Maria Bida Olivia S Tamayo-Shih, Daniel Wang, George Chang Chien

Critical revisions of the manuscript for important intellectual content: Jeimylo C de Castro, Daniel Wang, George Chang Chien

Administrative, technical or material support: Daniel Wang

Supervision: Jeimylo C de Castro

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.