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Biologic Injections During Hip Replacement

What is hip replacement surgery?

Hip replacement surgery, also known as total hip arthroplasty, is a surgical procedure in which a damaged or diseased hip joint is replaced with an artificial joint or prosthesis. This surgery is typically indicated for patients who experience significant hip pain and mobility limitations due to conditions such as arthritis, hip fractures, and bone tumors.

During the surgery, the surgeon removes the damaged cartilage and bone, then positions new metal, plastic, or ceramic joint surfaces to restore the alignment and function of the hip. The procedure is generally safe and effective, offering a long-term solution for individuals suffering from significant hip joint pain and dysfunction.

Biologics or biologic therapies are biological materials used in the regeneration and repair of bone and soft tissues. They can be implanted or injected to enhance outcomes from hip replacement surgery by providing the building blocks necessary for bone synthesis. The goal is to restore and preserve hip joint health.

They 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:

facilitate tissue repair and regeneration
harness the body’s own power to heal, reduce pain, improve function and provide an optimal environment for tissue regeneration 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.

  • 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 after the completion of the hip arthroscopic procedure.
  • Cellular therapies, such as bone marrow aspirate concentrate (BMAC), have the ability to produce new tissues. They include live cells injected into local tissues. Unlike blood derivatives, cell-based therapies produce a regenerative effect by incorporating them into injured tissues.

Studies have examined the use of biologics as an adjunct to surgery to restore function, improve recovery and outcomes. They have found that the application of platelet-rich plasma during surgery resulted in reduced pain and inflammation following surgery.

Both platelet-rich plasma and bone marrow aspirate concentrate may be used intra-operatively.

Bone Marrow Aspirate Concentrate (BMAC) has been used intra-operatively for hip arthroplasty procedures.

  • A 2020 study found that BMAC injections at the conclusion of the surgical procedure improved outcomes of both pain and function at 1- and 2-year follow-up. Moreover, BMAC is ideal because it has the ability to differentiate into bone and cartilage. BMAC is a safe and effective option for augmentation during total hip replacement.
  • Studies report that intraoperative cell-based therapies demonstrated more favorable patient-reported outcomes from hip surgery.

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.

Schedule a hip consultation

You can rely on experience and qualifications of clinicians at LALL Orthopedics +. Our team aims to provide safe and effective biologics treatments to improve your healing. When you or a loved one is suffering with an orthopedic problem, you have options. Contact the team at LALL Orthopedics + to schedule a consultation to receive the correct diagnosis and modern cutting-edge treatment options. We have offices in New Jersey, Manhattan, Philadelphia, and West Palm Beach, FL.


  • Lall AC, Walsh JP, Maldonado DR, Pinto LE, Ashberg LJ, Lodhia P, Radha S, Correia APR, Domb BG, Perez-Carro L, Marín-Peña O, Griffin DR. Teamwork in hip preservation: the ISHA 2019 Annual Scientific Meeting. J Hip Preserv Surg. 2020 Oct 9;7(Suppl 1):2-21. doi: 10.1093/jhps/hnaa037. PMID: 33072394; PMCID: PMC7546541.
  • Mullis BH, Gudeman AS, Borrelli J Jr, Crist BD, Lee MA, Evans AR. Bone healing: Advances in biology and technology. OTA Int. 2021 Apr 15;4(2 Suppl):e100(1-5). doi: 10.1097/OI9.0000000000000100. PMID: 37608854; PMCID: PMC10441680.
  • Kruel AVS, Ribeiro LL, Gusmão PD, Huber SC, Lana JFSD. Orthobiologics in the treatment of hip disorders. World J Stem Cells. 2021 Apr 26;13(4):304-316. doi: 10.4252/wjsc.v13.i4.304. PMID: 33959220; PMCID: PMC8080542.
  • Hernigou J, Verdonk P, Homma Y, Verdonk R, Goodman SB, Hernigou P. Nonoperative and Operative Bone and Cartilage Regeneration and Orthopaedic Biologics of the Hip: An Orthoregeneration Network (ON) Foundation Hip Review. Arthroscopy. 2022 Feb;38(2):643-656. doi: 10.1016/j.arthro.2021.08.032. Epub 2021 Sep 8. PMID: 34506886.
At a Glance

Ajay C. Lall, MD, MS, FAAOS

  • Board Certified – Orthopedic Surgery
  • Triple Fellowship Trained
  • Performs over 750 Surgeries Per Year
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