PRP vs. Cortisone for Hip Tendon Tear

Better than cortisone? A PRP injection is better for your partial hip tendon tear.

Lateral sided hip pain, commonly described as pain on the outside of the hip, pain with activity and pain lying on the affected side at night, is often referred to as trochanteric bursitis.  However, many of these patients also have a partial tear of their gluteal tendon, a tendon that inserts on the outside of the hip. Although some patients with a partial tendon tear will improve with physical therapy, anti-inflammatories and corticosteroid injections (CSI), 40% of patients will continue to have pain.  As a result, some physicians have started using leukocyte-rich platelet-rich plasma (LR-PRP) to improve long term outcomes for patients with partial gluteal tendon tears.

In this double-blind randomized controlled trial, 80 patients were randomly assigned to either receive LR-PRP or CSI injected into the tendon using ultrasound. Following the injection, all patients underwent the same rehabilitation program and results were assessed at 2, 6, and 12 weeks and then at 6,12, and 24 months using a score from 0-100 evaluating level of hip pain and function.

The PRP group did significantly better than the CSI group at 3 months and this improvement was magnified at 6 months. The LR-PRP group also demonstrated continued and maintained improvement up to 2 years.  73% of patients in the CSI group failed treatment at 3-6 months; they were then given a LR-PRP injection and also demonstrated improvement up to 2 years.

This study provides Level I Evidence, the highest level of evidence, demonstrating greater improvement in pain and function for LR-PRP injections compared to single CSI for patients with partial gluteal tendon tears. CSI improvement did not last beyond 3-6 months whereas the improvement with PRP injections lasted up to 2 years, proving PRP injections to have better long term outcomes.

Fitzpatrick J, et al. Leucocyte-Rich Platelet-Rich Plasma Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up. Am J Sports Med. 2019;47(5):1130-1137. doi: 10.1177/0363546519826969