Abstract:

Objective To assess the efficacy and the survival rate of the hip joint following the treatment of osteonecrosis of the femoral head （ONFH） with ultrasound?guided percutaneous intra?articular platelet?rich plasma （PRP） injection in combination with percutaneous silver needle thermalolysis. Methods Fifty?six patients diagnosed with ARCO （Association Research Circulation Osseous） stage Ⅱ ONFH were randomly allocated into two groups. The first group， designated as the PRP injection combined with silver needle thermalolysis group （Group R， n = 28）， and the second group， the steroid injection combined with silver needle thermalolysis group （Group S， n = 28）. Both groups underwent three injections （administered at 4?week intervals） and one session of silver needle thermalolysis. Outcome measures， including the Numerical Rating Scale （NRS） for pain assessment， Harris Hip Score （HHS）， daily consumption of non?steroidal anti?inflammatory drugs （etoricoxib） and tramadol， progression to ARCO stage Ⅲ， and the rates of surgical intervention， were recorded at baseline， 3 days， and 1， 3， 6， and 12 months after the treatment. Results When compared to the baseline， both groups manifested significant decreases in NRS scores and enhancements in HHS at all follow?up time points （P < 0.05）. Specifically， Group R demonstrated more favorable outcomes compared to Group S. At 3， 6， and 12 months， Group R had lower NRS scores （P < 0.01） and more notable improvements in HHS （P < 0.01）. Additionally， the daily analgesic consumption （etoricoxib and tramadol） in Group R was significantly lower than that in Group S at 3， 6， and 12 months （P < 0.01）. Moreover， Group R exhibited a significantly lower progression rate to ARCO stage III and a lower hip replacement surgery rate （P < 0.05）. Conclusions Ultrasound?guided intra?articular PRP injection in combination with silver needle thermalolysis expedites pain alleviation， enhances hip function， reduces analgesic dependence， and retards the progression of ONFH. This approach thus represents a clinically viable option for early?stage intervention.

Key words: ultrasound-guided, platelet-rich plasma, silver needle, hip joint cavity, osteonecrosis of the femoral head