Regenerative Therapy of Hip and Related Joints, Ligaments, and Tendons

Hip pain is a common presentation in orthopedic and interventional pain management settings. There are many causes of pain in the hip region with hip osteoarthritis being the most prevalent, affecting more than 240 million people worldwide causing significant disability and economic burden. Management of hip conditions can be challenging, given the multiple sources of pathology including intra-articular and extra-articular musculoskeletal causes and other non-orthopedic conditions like neurologic, infectious, autoimmune, or genetic etiologies that can present with hip pain. There is growing literature on the use of orthobiologics specifically platelet-rich plasma (PRP) and mesenchymal stem cells for the treatment of hip disorders in osteoarthritis, osteonecrosis, and gluteal tendinopathy. Regenerative procedures aim to provide long-lasting pain relief and increase in function by promoting tissue healing through the release of growth factors, proteins and other signaling, cells. This chapter presents an updated review of the current research in the use of orthobiologics for hip conditions. Although there is a need for more high-quality randomized controlled trials and standardization of protocols, there is increasing research on the use of regenerative medicine to manage hip pain with promising results and a good safety profile. Technical proficiency in ultrasound is essential in the diagnostic work-up and precise localization and delivery of the orthobiologics to the site of injury.