Reviewing the Use of Injections in Hip Osteoarthritis
Case Vignette
A) Physical Therapy
B) NSAIDS
C) Intra-articular injection
D) Proper footwear

Image 1. Example of intra-articular hip injection with ultrasound guidance (adopted from arthroscopytechniques.org)
IA injections seem to help. A 2015 meta-analysis found that intra-articular treatments were superior to NSAIDS for knee OA (Bannuru 2015). That group found HA to be most effective. Other studies have found varying degrees of benefits from various types of injections (We 2017, Migliore 2008, Bennel 2017, Dall’Oca 2019).
Study
Summary
– Read More: https://wikism.org/Hip_Osteoarthritis
Case Conclusion
Answer C. Intra-articular injections are a major component of treating hip OA. This can include corticosteroids, platelet rich plasma and hyaluronic acid among other options. However this would not routinely be considered first line treatment. Physical therapy, NSAIDS and correcting footwear if necessary would be considered first line therapy.
Citations
- Gazendam, Aaron, et al. “Intra-articular saline injection is as effective as corticosteroids, platelet-rich plasma and hyaluronic acid for hip osteoarthritis pain: a systematic review and network meta-analysis of randomised controlled trials.” British Journal of Sports Medicine 55.5 (2021): 256-261.
- Bannuru, Raveendhara R., et al. “Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis.” Annals of internal medicine 162.1 (2015): 46-54.
- He, Wei-wei, et al. “Efficacy and safety of intraarticular hyaluronic acid and corticosteroid for knee osteoarthritis: A meta-analysis.” International Journal of Surgery 39 (2017): 95-103.
- Migliore, Alberto, and Mauro Granata. “Intra-articular use of hyaluronic acid in the treatment of osteoarthritis.” Clinical interventions in aging 3.2 (2008): 365.
- Bennell, Kim L., David J. Hunter, and Kade L. Paterson. “Platelet-rich plasma for the management of hip and knee osteoarthritis.” Current rheumatology reports 19.5 (2017): 1-10.
- Dall’Oca Carlo, Breda Stefano, et al. “Mesenchymal Stem Cells injection in hip osteoarthritis: preliminary results.” Acta Bio Medica: Atenei Parmensis 90.Suppl 1 (2019): 75.