Symposium: Evidence for the Use of Intra-articular Cortisone or Hyaluronic Acid Injection in the Hip
Authors: Chandrasekaran S, Lodhia P, Suarez-Ahedo C, et al.
DOI: 10.1093/jhps/hnv020
Purpose:
Systematic review of diagnostic and therapeutic intra-articular hip injections—corticosteroids, hyaluronic acid (HA), and platelet-rich plasma (PRP)—in osteoarthritis (OA) and femoroacetabular impingement (FAI).
Methods:
Analyzed 72 studies evaluating efficacy, safety, and indications.
Key Findings:
- Diagnostic injections show high sensitivity and specificity for intra-articular hip pain.
- Corticosteroids provide superior pain relief in hip OA compared to HA and PRP; higher doses extend benefit duration.
- Injection volume does not significantly impact outcomes.
- No increased infection risk observed in patients receiving corticosteroids prior to hip arthroplasty.
- Limited and inconclusive evidence supporting injections for labral tears or FAI.
What Does This Mean for Providers?
- Corticosteroid injections remain the most evidence-supported nonoperative treatment for hip OA pain relief.
- Diagnostic injections are valuable for confirming intra-articular sources of pain.
- Use caution and counsel patients appropriately when considering injections for labral pathology or FAI due to limited efficacy data.
- No contraindication exists for corticosteroid injections in patients who may undergo future hip arthroplasty.