A Systematic Review of Recent Developments in Platelet-Rich Plasma Therapy in Hip Osteoarthritis: Variability in Protocols and Clinical Outcomes (2019-2024).

Hip osteoarthritis (OA) is a chronic, progressive degenerative joint disorder associated with significant morbidity and limited non-surgical treatment options. Over the past 20 years, Platelet-rich plasma (PRP) has garnered increasing interest as a conservative intervention in the setting of OA; however, its clinical efficacy in hip OA remains inconclusive due to substantial heterogeneity in preparation protocols and administration methods. This systematic review aims to examine randomized controlled trials (RCTs) published between 2019 and 2024 that evaluated the efficacy of PRP in the management of hip OA, with specific criteria including the use of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and/or the Visual Analog Scale (VAS) for outcome measurement. Three RCTs met the eligibility criteria. While short-term improvements in pain and function were observed in patients with mild to moderate OA, long-term benefits were inconsistent. Considerable variability in PRP composition (leukocyte-rich versus leukocyte-poor), activation techniques, injection schedules, and follow-up durations was evident across studies. Particularly, one trial demonstrated no significant advantage of PRP over placebo. Methodological limitations, including lack of blinding, underreporting of PRP characteristics, and protocol heterogeneity, impeded the ability to draw definitive conclusions. Although PRP may provide short-term symptomatic relief in early-stage hip OA, the absence of standardized protocols highlights the need for rigorous, long-term randomized controlled trials that employ consistent classification systems (eg, PAW or MARSPILL) and stratified patient populations to inform evidence-based clinical guidelines.