Arthroscopy or Stem Cells for Hip Pain?
Arthroscopy for Labral tears of the hip has increased in recent years. In the past these were treated with surgery now it is becoming increasingly more frequent. Especially in athletes.
There are many problems with treating these hip Labral tears. MRIs may be misleading with false positives. Some are advocating MRI- arthrography or MRA as more sensitive. There is an MRI available today that has contrast injected into the hip joint to hopefully better visualize Labral tears.
Only now are long term studies looking at the effect that surgery on the Labrum has. A recently presented study showed that the presence of arthritis with a Labral tear is predictor of a poor outcome. Moreover, the a large percentage of those who underwent arthroscopic treatment for a Labral tear ended up with an eventual total hip replacement.
What if surgery is deferred and the patient opts for stem cells instead?
There is no data to compare the two yet. My suspicion is that surgery on the the Labrum accelerates the already present arthritis and propels the patient towards a hip replacement. The data is long standing when you surgically treat the knee meniscus arthritis is potentiated. Surgery is a form of trauma and trauma accelerates arthritis, so it is no surprise that Labral surgery would be any different.
The use of the patients own stem cells for hip pain, and regeneration in this case, would avoid trauma, and if regeneration occurs, the arthritis’ clock is set back. Even if the arthritis is halted with no further degeneration on followup x-rays this is positive as arthritis is progressive. Logically speaking using Regenerative Medicine therapies like Platelet Rich Plasma (PRP) and Stem Cells for hip pain become attractive alternatives to surgery, especially without the debilitating post-surgery period.
