Platelet rich plasma for hip labral tear

Ross Hauser, MDRoss Hauser, MD

When thinking through the root cause of chronic pain and sports injury, Prolotherapy should make sense as the first line treatment in many of these injuries. Unfortunately standard treatments for chronic pain injuries ignore the root cause, going after the symptoms and potentially causing more injury and pain. Labral tears are one of these injuries. An article published in Current Reviews in Musculoskeletal Medicine conducted a comprehensive review of hip labral tears that pointed out some crucial facts about these tears1. In short, the hip surgeries that remove or debride the hip labrum are taking away from the vital function of the labrum.

Hip labral repair


Hip labral tear


Treatments for hip labral tears


Problems with surgery for hip labral tear


“Without the labrum, the articular cartilage must withstand significantly increased pressure, and a compromise of this system could lead to early joint deterioration. A study testing a labrum-free model of the hip showed that, without the labrum, contact stress may increase by as much as 92%. A tear in the labrum would also likely destabilize the hip joint. This explains why there is an association between acetabular labral tears and early onset OA.”1


Prolotherapy for hip labral tears

Unfortunately removing any part of the labrum will lead to further degeneration and most likely OA. Since the labrum is vital to hip joint function, both doctors and patients should desire to preserve the hip labrum. While standard treatments prove unsuccessful, Comprehensive Prolotherapy is an excellent alternative to surgery for hip labral tears. Specifically, Platelet Rich Plasma Prolotherapy (PRP) can be greatly beneficial in delivering growth factors to the damaged labrum.

Prolotherapy works very well for labrum (hip and shoulder) and menisci degeneration and tears and even more so when Platelet Rich Plasma Therapy (PRP) is added. So what is PRP and how does it work?

What is PRP?




Platelet rich plasma for labral tear and meniscal injury

The preparation of therapeutic doses of growth factors consists of an autologous blood collection (blood from the patient), plasma separation (blood is centrifuged), and application of the plasma rich in growth factors (injecting the plasma into the area.) In other words, PRP is done just like any other Prolotherapy treatment, except the solution used for injection is plasma enriched with growth factors from your own blood. Typically patients are seen every 4-6 weeks like other Prolotherapy patient. Typically two to six visits are necessary per area.

Where is PRP used?

In the scientific literature are reports of soft tissue injuries treated with PRP including tendinopathy, tendonitis, acute and chronic muscle strain, muscle fibrosis, ligamentous sprains and joint capsular laxity. PRP has also been utilized to treat intra-articular injuries. Examples include arthritis, arthrofibrosis, articular cartilage defects, meniscal injury, and chronic synovitis or joint inflammation.


Is there research on Platelet Rich Plasma Therapy? The answer to this question depends on what condition you are talking about and who you ask. In regard to lateral epicondylosis, according to one author, “There is strong pilot-level evidence supporting the use of Prolotherapy, polidocanol, autologous white blood and platelet rich plasma injections in the treatment of lateral epicondylosis.” If you ask Dr. Hauser, “Absolutely Prolotherapy with or without PRP works great for lateral epicondylosis (Tennis Elbow/lateral elbow pain)! This is just one example. In my experience, PRP works great for tendinosis, menisci or labrum degeneration or tears, and ligament injuries not healing with other Prolotherapy solutions.

Why PRP makes sense? Ligament injury like tendon pathology often involves tissues with poor blood supplies. Tendon pathology has many manifestations, for instance from spontaneous rupture to chronic tendinitis or tendinosis (degenerated tendon); the etiology and pathology of each are very different and poorly understood. Tendon is a comparatively poorly vascularized tissue that relies heavily upon synovial fluid diffusion to provide nutrition. During tendon injury, as with damage to any tissue, there is a requirement for cell infiltration from the blood system to provide the necessary reparative factors for tissue healing. Obviously if a tissue has a poor blood supply (like tendons and ligaments) then the reparative factors necessary for healing are likely not going to get to the injured area or not mount a sufficient response to fully repair the tissue. Thus, you see the need for Prolotherapy – with or without PRP! One of the growth factors in PRP is vascular growth factor which helps with new blood vessel formation. It could be this growth factor and others that causes the remarkable healing with PRP.

What about using PRP in osteoarthrtic joints? If you look at the various studies on PRP, a theoretical basis for using PRP to effect joint pathology exists at this time. Study authors conclude, “Intra-articular administration of PRGF (platelet rich growth factor) might be beneficial restoring hyaluronic acid concentrations and switching angiogenesis to a more balanced status, but does not halt the effects of IL-1 beta on synovial cells.”

What does this mean? Bottom line in this study – PRGF significantly enhanced hyaluronic acid secretion compared with platelet-poor preparations. When you see hyaluronic acid, you have to think joint fluid. If you think more joint fluid, think of the joint being lubricated. What would happen to a joint that was not lubricated if it were to become more lubricated? You got it, less stiffness, more motion, and ,of course, less pain! This is what we have found with Prolotherapy and with Prolotherapy and PRP.

What is really great about PRP? Ultrasound studies before and after PRP are showing that the tissue is healing! This is something we knew all along with Prolotherapy, but we just had a hard time proving it! Now that ultrasounds are showing degenerated tendons being regenerated with Prolotherapy PRP, the critics are being answered. Yes, it is true that Prolotherapy stimulates the body to repair painful areas. This can be done by injecting simple solutions such as dextrose in the area, to more complicated solutions using the use of Glucosamine sulfate, manganese, natural hormones, to a person’s own growth factors through the use of PRP.

So what are you to do? If you have pain or know of someone in pain that you care about, then let them know that there is a potential cure for chronic pain and that cure is Prolotherapy!




