Platelet Rich Plasma vs Hyaluronic-Acid in Hip OA (Osteoarthritis)
Condition: Hip Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Hip
Study type: Interventional

Summary: 
      The objective of this study is to compare the clinical efficacy of intra-articular injections
      of autologous platelet rich plasma (PRP) vs hyaluronic acid (HA) for symptomatic early
      osteoarthritis (OA) of the hip. Secondarily, this study aims to determine the feasibility and
      safety of treating early OA of the hip with HA and PRP.
    

Detailed description: 
      Osteoarthritis (OA) is a common, painful condition affect adults and causes mobility
      disability in the United States and Europe. Unfortunately, there is no agents available that
      halt OA progression. Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) have
      suboptimal effectiveness, and there is concern of systemic side effects.

      A large challenge is the development of appropriate and effective therapy in patients with
      OA. Currently, the most suitable route for administering OA therapy appears to be
      intra-articular injections that allow accumulation of critical doses of the drug within the
      damaged area and also reduce the risk of systemic side effects.

      The primary objective of this study is to compare the clinical efficacy of intra-articular
      injections of Platelet Rich Plasma (PRP) vs. Hyaluronic Acid for symptomatic early OA of the
      hip. Secondarily, the study aims to evaluate the safety and feasibility of both medications
      delivered.

      Patients, which meet inclusion criteria, are confirmed eligible, and agree to enroll in the
      study, would be randomized and treated with either three intra-articular PRP injections or
      three intra-articular Hyaluronic Acid injections. If the patient has OA in both hips, they
      will be randomized to receive the same injection in both hips. The Primary investigator will
      be unblinded to the treatment that the subject is randomized to. The PI will only be involved
      in the initial assessment of the patient and the actual injections. All of the follow up
      visits, clinical assessments and outcome scores will be performed by the sub-investigator,
      who will also be the examining physician. The sub-investigator will be blinded to the
      treatment throughout the study. All of the study subjects will be blinded to which treatment
      that they are assigned to.

      Physical exams will be performed to assess range of motion of the hip joint. The difference
      in ranges of motion will be statistically compared at different time points between the two
      groups to determine the difference in improvement between the two compared to baseline.

      The primary efficacy outcome will be defined as the percentage of patients having a 50%
      decrease in the summed score for the WOMAC pain subscale from baseline to week 24. We will
      measure this outcome by applying the WOMAC questionnaire compared with baseline therapy. The
      secondary efficacy outcomes will also include IHOT and Non Arthritic Hip Score.

      An anterior posterior hip radiograph will be performed at 12 months and 24 months to assess
      Kellgren-Classification and compared to baseline.
    

Intervention name(s): PRP; Hyaluronic Acid
Intervention type(s): Biological; Device
Intervention description(s): Each PRP preparation requires a total of 36 ml of peripheral blood. This will be obtained via venapuncture and collected in four 9 ml extraction tubes containing 3.8% sodium citrate. The tubes are then centrifuged at 640 rpm for 8 minutes at room temperature. The 1ml plasma fraction located above the buffy coat is aspirated from each tube and dispensed into the fractioning tube. The entire PRP process takes place under laminar airflow. Immediately prior to injection, calcium chloride is is drawn up from the activator ampoule with the activation syringe and is added to the PRP fractioning tube. The activated PRP is then injected in its entirety into the hip joint under strict aseptic technique.; Hyaluronic acid is supplied as a non-pyrogenic solution in 2.5 ml pre-filled syringes and is administered by intra-articular injection using a 22-23 gauge needle. The full 2.5 ml is injected in one joint under strict aseptic administration.
Other intervention name(s): SUPARTZ
Intervention MeSH terms: Hyaluronic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Hip, Chondropenia, Osteoarthritis.