Biologic Injections During Hip Labral Repair

Hip labral repair is a surgical procedure used to correct a tear in the labrum of the hip joint. Hip labral repair is the gold standard choice to preserve the hip joint.

Biologics or biologic therapies are a class of nondrug treatments that are developed from naturally-derived substances such as sugars, proteins, nucleic acids, and a combination of these substances, or they may be living things such as cells and tissues. They may be used to:

• help accelerate healing of injuries and damage to bone, cartilage, muscles, ligaments and tendons
• improve healing after surgery

There are blood derived therapies such as such as platelet-rich plasma, and cell-based therapies such as stem cells, and bone marrow concentrate. They may be isolated from blood, and other substances like hyaluronic acid, a naturally-occurring sugar molecule found in the skin and synovial fluid of joints that acts as a lubricant.

• Blood-derived therapies such as platelet-rich plasma, deliver cytokines (proteins) that are crucial in controlling the growth and activity of immune and blood cells and control inflammation and healing substances like platelets. Other blood derived therapies include growth factors that stimulate cell mechanisms like collagen production. They are delivered to the site of injury.
• Cellular therapies, such as bone marrow aspirate concentrate (BMAC), have the ability to produce new tissues. They include live cells injected into local tissues and include mesenchymal stem cells. Unlike blood derivatives, cell-based therapies produce a regenerative effect by incorporating them into injured tissues.

1. Tissue Repair and Regeneration: Biologics such as platelet-rich plasma (PRP) and stem cells are used to promote the healing of damaged tissues.
2. Surgical Healing: Biologics may be used during surgery to aid in healing from surgeries such as ACL reconstruction or rotator cuff repair. Biologics may be used to accelerate the healing process and improve the quality of the repaired tissue.

Studies have examined the use of biologics during arthroscopic surgery.  They have found that the application of platelet-rich plasma during surgery resulted in reduced pain postoperatively and reduced inflammation following hip arthroscopy.

In addition to PRP, Bone Marrow Aspirate Concentrate (BMAC) has been used intra-operatively for hip arthroscopy procedures.

• A 2020 study found that BMAC injections at the conclusion of the arthroscopy procedure improved outcomes of both pain and function at 1- and 2-year follow-up. Moreover, BMAC are ideal because they have the ability to differentiate into cartilage. BMAC is a safe and effective option for augmentation of labral healing.
• A 2023 study reports that intraoperative platelet-rich plasma and cell-based therapies found that cell-based therapy demonstrated more favorable patient-reported outcomes defining success in hip labral repair.

Biologics like stem cells and growth factors can be used in procedures aimed at repairing or regenerating damaged cartilage including hip labral cartilage, especially in young patients or athletes with cartilage injuries.

Biologics that are harvested from your own body and used to treat you are safe. They are not used in people with malignancies or recent remissions.