Use of Leukocyte-Rich PRP or Leukocyte-Free PRP in the Treatment of Hip Osteoarthritis

NCT ID: NCT05497349

Last Updated: 2025-09-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

230 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-05

Study Completion Date

2026-10-31

Brief Summary

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The aim of the study is to compare the efficacy up to 12 months of two different types of PRP (PRP with leukocytes vs PRP depleted of leukocytes) in the echo-guided infiltrative treatment of hip OA by including 230 patients in the study and evaluating them through subjective (using the WOMAC score as the primary outcome) and objective clinical scores.

Detailed Description

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Platelet-rich plasma (PRP) has recently emerged as an attractive biological approach to address joint degeneration. It has gained increasing attention because of the high concentration of growth factors, cytokines, and bioactive molecules stored in platelet-rich α-granules, which have been shown to participate in joint tissue homeostasis, being involved in both healing processes and immunoregulation and modulation of inflammation. Several preparation methods are available for PRP, which can give products with different compositions and characteristics.The presence of leukocytes is one of the most debated aspects of PRP efficacy, and is used as one of the main discriminators to distinguish different PRPs.

Patients with OA of the hip will be included in a randomized controlled, double-blind trial, in which one group of patients will be treated with 3 infiltrations of PRP with leukocytes and one group will be treated instead with 3 infiltrations of PRP without leukocytes. A total of 230 patients will be included and will undergo infiltrative treatment after collecting informed consent for study participation. Patients will be clinically evaluated before the injection procedure and at 2-6-12 months after treatment by the medical staff.

Conditions

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Hip Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study is a double-blinded RCT in which one group of patients will be treated with 3 intra-articular injection of Leukocyte Rich-PRP, and one group will be treated with 3 intra-articular injection of Leukocyte Poor- PRP
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
This is a double-blind randomized controlled trial with allocation 1:1. Patient blinding will be provided during the injection treatment.

Study Groups

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Leukocyte Rich-PRP Injection

Three infiltrations of Leukocyte Rich Platelet Rich Plasma

1 infiltration weekly, for 3 weeks

Group Type EXPERIMENTAL

Leukocyte Rich- PRP injection

Intervention Type OTHER

Autologous Leukocyte Rich-Platelet Rich Plasma will be injected in the hip joint

Leukocyte Poor- PRP Injection

Three infiltrations of Leukocyte Poor-Platelet Rich Plasma

1 infiltration weekly, for 3 weeks.

Group Type ACTIVE_COMPARATOR

Leukocyte Poor- PRP injection

Intervention Type OTHER

Autologous Leukocyte Poor-Platelet Rich Plasma will be injected in the hip joint

Interventions

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Leukocyte Rich- PRP injection

Autologous Leukocyte Rich-Platelet Rich Plasma will be injected in the hip joint

Intervention Type OTHER

Leukocyte Poor- PRP injection

Autologous Leukocyte Poor-Platelet Rich Plasma will be injected in the hip joint

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Signs and symptoms of hip OA (pain intensity of at least 4 points and not more than 8 of VAS pain - 0-10 scale in the previous week);
* Radiographic signs of hip OA (Grade 1-2 according to Tonnis classification) or MRI signs (chondropathy or minimal labrum degeneration without acute lesions) even if Grade 0.
* Unilateral involvement; Hemoglobin \> 11 g/dl;
* Platelet count \> 150,000 plt/mm3 (Recently performed CBC examination);
* Negative serological tests for HBsAg, HCV Ab, HIV-1-2 Ab
* No clinically significant electrocardiographic changes (Recently performed ECG).
* Ability and consent of patients to actively participate in clinical follow-up;- Signature of informed consent.

Exclusion Criteria

* Patients unable to express consent;
* Patients undergoing infiltration of other substance in the previous 6 months;
* Patients undergoing lower limb surgery to be treated in the previous 12 months;
* Patients with malignant neoplasms;
* Patients with rheumatic diseases;- Patients with uncontrolled diabetes;-Patients with hematological diseases (coagulopathies);
* Patients on anticoagulant-antiaggregant therapy that cannot be discontinued for at least 3 days prior to blood collection;
* Patients with uncontrolled thyroid metabolic disorders;
* Patients abusing alcoholic beverages, drugs or medications;
* Body Mass Index \> 30;
* Patients who have taken NSAIDs in the 3 days prior to blood draw;
* Patients with cardiovascular disease for whom 300 ml blood draw would be contraindicated;
* Patients with recently performed CBC examination with Hb\< 11 g/dl and Platelet values \< 150,000 plt/mm3.
* Positive serological tests for HBsAg, HCV Ab, HIV-1-2 Ab
* Pregnant and/or fertile women.
* Pain intensity less than 4 points or greater than 8 in accordance with the VAS scale.
* Patients with other hip pathologies: acetabular protrusion, concentric migration of the femoral head, presence of excessive deformity resulting from acetabular or femoral head dysplasia, collapse deformity, and deformed femoral head sequelae of Perthes disease or osteonecrosis of the femoral head.
* Previous extensive surgery of the reference joint (osteotomy around the hip, open or arthroscopic osteochondroplasty for femoro-acetabular conflict).
Minimum Eligible Age

35 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istituto Ortopedico Rizzoli

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dante Dallari, MD

Role: PRINCIPAL_INVESTIGATOR

Istituto Ortopedico Rizzoli

Locations

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Istituto Ortopedico Rizzoli

Bologna, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Dante Dallari, MD

Role: CONTACT

6366318 ext. 051

Roberta Licciardi, MSc

Role: CONTACT

6366567 ext. 051

Facility Contacts

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Dante Dallari, MD

Role: primary

6366567

Roberta, MSc

Role: backup

6366567 ext. 051

References

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Mobasheri A, Batt M. An update on the pathophysiology of osteoarthritis. Ann Phys Rehabil Med. 2016 Dec;59(5-6):333-339. doi: 10.1016/j.rehab.2016.07.004. Epub 2016 Aug 18.

Reference Type BACKGROUND
PMID: 27546496 (View on PubMed)

Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, Bridgett L, Williams S, Guillemin F, Hill CL, Laslett LL, Jones G, Cicuttini F, Osborne R, Vos T, Buchbinder R, Woolf A, March L. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014 Jul;73(7):1323-30. doi: 10.1136/annrheumdis-2013-204763. Epub 2014 Feb 19.

Reference Type BACKGROUND
PMID: 24553908 (View on PubMed)

Fu M, Zhou H, Li Y, Jin H, Liu X. Global, regional, and national burdens of hip osteoarthritis from 1990 to 2019: estimates from the 2019 Global Burden of Disease Study. Arthritis Res Ther. 2022 Jan 3;24(1):8. doi: 10.1186/s13075-021-02705-6.

Reference Type BACKGROUND
PMID: 34980239 (View on PubMed)

Boffa A, Salerno M, Merli G, De Girolamo L, Laver L, Magalon J, Sanchez M, Tischer T, Filardo G. Platelet-rich plasma injections induce disease-modifying effects in the treatment of osteoarthritis in animal models. Knee Surg Sports Traumatol Arthrosc. 2021 Dec;29(12):4100-4121. doi: 10.1007/s00167-021-06659-9. Epub 2021 Aug 2.

Reference Type BACKGROUND
PMID: 34341845 (View on PubMed)

Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, Tschon M, Giavaresi G. Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study. Am J Sports Med. 2016 Mar;44(3):664-71. doi: 10.1177/0363546515620383. Epub 2016 Jan 21.

Reference Type BACKGROUND
PMID: 26797697 (View on PubMed)

Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Arthroscopy. 2011 Nov;27(11):1490-501. doi: 10.1016/j.arthro.2011.05.011. Epub 2011 Aug 10.

Reference Type BACKGROUND
PMID: 21831567 (View on PubMed)

Ornetti P, Nourissat G, Berenbaum F, Sellam J, Richette P, Chevalier X; under the aegis of the Osteoarthritis Section of the French Society for Rheumatology (Societe Francaise de Rhumatologie, SFR). Does platelet-rich plasma have a role in the treatment of osteoarthritis? Joint Bone Spine. 2016 Jan;83(1):31-6. doi: 10.1016/j.jbspin.2015.05.002. Epub 2015 Jul 7.

Reference Type BACKGROUND
PMID: 26162636 (View on PubMed)

Battaglia M, Guaraldi F, Vannini F, Rossi G, Timoncini A, Buda R, Giannini S. Efficacy of ultrasound-guided intra-articular injections of platelet-rich plasma versus hyaluronic acid for hip osteoarthritis. Orthopedics. 2013 Dec;36(12):e1501-8. doi: 10.3928/01477447-20131120-13.

Reference Type BACKGROUND
PMID: 24579221 (View on PubMed)

Di Sante L, Villani C, Santilli V, Valeo M, Bologna E, Imparato L, Paoloni M, Iagnocco A. Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis. Med Ultrason. 2016 Dec 5;18(4):463-468. doi: 10.11152/mu-874.

Reference Type BACKGROUND
PMID: 27981279 (View on PubMed)

Ye Y, Zhou X, Mao S, Zhang J, Lin B. Platelet rich plasma versus hyaluronic acid in patients with hip osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg. 2018 May;53:279-287. doi: 10.1016/j.ijsu.2018.03.078. Epub 2018 Apr 5.

Reference Type BACKGROUND
PMID: 29626641 (View on PubMed)

Di Martino A, Boffa A, Andriolo L, Romandini I, Altamura SA, Cenacchi A, Roverini V, Zaffagnini S, Filardo G. Leukocyte-Rich versus Leukocyte-Poor Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Trial. Am J Sports Med. 2022 Mar;50(3):609-617. doi: 10.1177/03635465211064303. Epub 2022 Feb 1.

Reference Type BACKGROUND
PMID: 35103547 (View on PubMed)

Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 Dec;15(12):1833-40.

Reference Type BACKGROUND
PMID: 3068365 (View on PubMed)

Other Identifiers

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PRP22-Hip

Identifier Type: -

Identifier Source: org_study_id

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