In the The Open Rehabilitation Journal research describes the effectiveness of Prolotherapy for hip labral tear and groin pain that concluded Prolotherapy for acetabular labral tear appears to be a safe and potentially effective treatment.
In this research, Prolotherapy was found to provide connective tissue growth responses and provide clinical benefit with low risks in musculoskeletal conditions. Further, Prolotherapy can be a cost-effective alternative to surgery for patients with hip pain and labral tear.
The full article is available via the link and downloads as a PDF (Adobe) file.
Ross. A. Hauser, Amos Orlofsky. Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions:Rationale and Retrospective Study The Open Rehabilitation Journal, 2013, 6, 59-68 59 1874-9437/13 2013 Bentham Open
Prolotherapy Research Hip Labum Repair
This research supports our thinking that Prolotherapy should be a first line treatment in hip labrum tears. Unfortunately this is not the thinking in the entire medical community. An article published in Current Reviews in Musculoskeletal Medicine conducted a comprehensive review of hip labral tears that pointed out that hip surgeries that remove or debride the hip labrum are taking away from the vital function of the labrum and indeed motion of the hip.1
Hip labral repair
The hip labrum functions as a shock absorption and provides hip stability. When looking at the function of the hip labrum it is clear that a tear is more than significant. Damage to the labrum, typically caused by trauma, hypermobility or degeneration, is linked to osteoarthritis. It is known that the anterior and superior aspects of the labrum contain free nerve endings and sensory nerve organs; meaning damage produces pain, pressure and deep sensation.
Problems with surgery for hip labral tear
The study in Current Reviews in Musculoskeletal Medicine mentioned above points out the problem with completely removing the labrum but also points to problems with tears:
“Without the labrum, the articular cartilage must withstand significantly increased pressure, and a compromise of this system could lead to early joint deterioration. A study testing a labrum-free model of the hip showed that, without the labrum, contact stress may increase by as much as 92%. A tear in the labrum would also likely destabilize the hip joint. This explains why there is an association between acetabular labral tears and early onset osteoarthritis.”1
Prolotherapy for hip labral tears
In our research reported above, patients reported gains in functionality following Prolotherapy. All patients who reported walking limitations at the start of treatment experienced improved walking distance. Six of 19 patients reported inability to walk more than 1 block pre-treatment, while after treatment all patients could walk one-half mile. Eighteen of 19 patients with compromised ability to exercise at start of treatment reported improved ability to exercise.
Prolotherapy research for hip pain
Removing tissues from joints may provide a temporary benefit, but long-term, the patient is left with a weaker joint, more susceptible to degeneration.
In past reasearch published in the Journal of Prolotherapy we sought to show how Prolotherapy could provide high levels of patient outcome satisfaction while avoiding hip surgery. Here is what we reported:
We examined Sixty-one patients, representing 94 hips, who had been in pain an average of 63 months We treated these patients quarterly with Hackett-Hemwall dextrose Prolotherapy.
This included a subset of 20 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of eight patients who were told by their doctor(s) that surgery was their only option.
Patients were contacted an average of 19 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms and activities of daily living, before and after their last Prolotherapy treatment.
Results: In these 94 hips, pain levels decreased from 7.0 to 2.4 after Prolotherapy; 89% experienced more than 50% of pain relief with Prolotherapy; more than 84% showed improvements in walking and exercise ability, anxiety, depression and overall disability; 54% were able to completely stop taking pain medications.
We concluded: “The Hackett-Hemwall technique of dextrose Prolotherapy used on patients who presented with over five years of unresolved hip pain were shown in this retrospective pilot study to improve their quality of life even 19 months subsequent from their last Prolotherapy session. The 61 patients with 94 hips treated reported significantly less pain, stiffness, crunching sensation, disability, depressed and anxious thoughts, medication and other pain therapy usage, as well as improved walking ability, range of motion, sleep, exercise ability, and activities of daily living. This included patients who were told there were no other treatment options for their pain or that surgery was their only option. The results confirm that Prolotherapy is a treatment that should be highly considered for people suffering with chronic hip pain.”(2)
On the caringmedical.com website we have posted many articles and updates on hip pain and hip replacement treatment options. These articles also include extensive information on Stem Cell Therapy and Platelet Rich Plasma Therapy for advanced hip pain
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1. Groh MM, Herrara J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med. 2009 June; 2(2): 105–117.
2. Hauser R, Hauser M, A Retrospective Study on Hackett-Hemwall Dextrose Prolotherapy for Chronic Hip Pain at an Outpatient Charity Clinic in Rural Illinois. Journal of Prolotherapy. 2009;2:76-88.