Comparing the effect of intra-articular injection of platelet-rich plasma (PRP) with corticosteroids on the treatment of osteonecrosis of the femoral head

Abstract Introduction Osteonecrosis of the femoral head is a common orthopedic problem that mainly affects young people. The main causes of this disease include the use of steroid drugs, some medications, and trauma to the joint. According to the Ficot classification, this disease is divided into four stages, and the more advanced the stage, the more extensive intervention is required. In the early stages, methods such as core decompression and the use of platelet-rich plasma (PRP) are recommended to improve the results. This study aims to evaluate and compare the effectiveness of two treatment methods, PRP and corticosteroid injection, in improving the clinical and radiological symptoms of patients with osteonecrosis of the femoral head. Methods This is a retrospective case-control study in which patients aged 18 to 70 years with a diagnosis of stage 1 or 2 osteonecrosis of the femoral head based on MRI referred to the orthopedic clinic of Shahid Bahonar Hospital, Kerman, Iran, were studied. Based on the treatment received, the patients were categorized into two groups: PRP injection and corticosteroid injection. Patients will be evaluated using MRI, modified Kerboul angle, Harris Hip Score, Foot Health Questionnaire (FSHQ-Br), and McGill Pain Questionnaire (MPQ) at specific time intervals. The results will be analyzed using statistical tests and the significance level is considered less than 0.05. Results 64 patients with osteonecrosis of the femoral head participated in this study. This study showed that both PRP and corticosteroids are effective in improving symptoms and function in patients with osteonecrosis of the femoral head, although PRP had better long-term results. Corticosteroids showed more immediate pain relief and improved function in the short term (3 months), while PRP provided more sustained improvement in all evaluated outcomes at 6 months. In addition, PRP showed a significant reduction in radiological progression of osteonecrosis compared with corticosteroids. These findings are consistent with the existing evidence of beneficial effects of PRP on angiogenesis, osteogenesis, and inhibition of inflammation in the treatment of osteonecrosis of the femoral head. Conclusion The results of this study indicated that the selection of optimal treatment should be based on a comprehensive assessment of each patient’s clinical status, preferences, and treatment goals. Overall, PRP may be a promising treatment option to improve outcomes and quality of life in patients with osteonecrosis of the femoral head.