Does PRP Work for Hip Osteoarthritis. The Joint, Not the Tendon

Key points

• A 2024 systematic review in Cure us of 5 randomised trials of PRP for hip osteoarthritis, 43 to 111 patients each, found every trial reported significant pain reduction and functional improvement with no major adverse events, with leukocyte-poor PRP outperforming leukocyte-rich and a single injection outperforming multiple.

• A 2022 meta-analysis in Arthroscopy of 6 randomised trials, 211 PRP patients and 197 hyaluronic acid patients with a mean follow up of around 12 months, found no significant difference between PRP and hyaluronic acid on WOMAC, pain or Harris Hip Score.

• A 2023 meta-analysis of 7 trials and 478 patients found PRP gave lower WOMAC pain than hyaluronic acid at 6 months but not at 1 to 2 months or 12 months, and a 2025 meta-analysis of 190 patients found adding hyaluronic acid to PRP made pain worse at 3 and 12 months.

• NICE guideline NG226 says do not offer hyaluronic acid injections for osteoarthritis, noting potential harmspecifically in the hip, and limits corticosteroid to 2 to 10 weeks of relief.

If you have hip arthritis and want to know whether PRP has a role, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will look at your imaging before recommending anything.

First, which hip pain this article is about

Pain on the outside of the hip that is worst lying on that side at night is usually the gluteal tendons, not thejoint, and PRP has its own evidence and its own article for that. This article is about osteoarthritis of the hipjoint itself, which presents differently. The pain sits in the groin or the front of the thigh, sometimes referred tothe knee, is worse with walking, getting out of a chair and putting on shoes and socks, and comes withstiffness and a shrinking range of movement, particularly rotating the hip inwards. It is confirmed on an X-rayrather than an ultrasound.

The distinction matters because the two conditions are often confused, the treatments are different, and thejoint injection is technically harder. The hip joint sits deep under muscle and close to the femoral vessels andnerve, so any injection into it, of anything, should be ultrasound guided by someone who does it regularly.Guided injections reach the target around 96 percent of the time against 78 percent by landmarks acrossjoints, and the hip is the joint where a miss matters most.

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What the 5 randomised trials found

The most useful summary of PRP for hip osteoarthritis is the 2024 systematic review in Cureus, whichselected randomised trials that reported adverse events and found 5, with 43 to 111 patients each andpreparation methods that varied between open and closed systems. Every trial reported significant reductionsin pain and improvements in function with PRP, and no major adverse events. Within that evidence 2 patternsstood out. Leukocyte-poor preparations outperformed leukocyte-rich ones, and a single injectionoutperformed a course of multiple injections, which runs against the assumption that more sessions mean abetter result and against the 3-injection protocols many clinics sell.

The 2023 meta-analysis of 7 trials and 478 patients adds timing. PRP gave significantly lower WOMAC painthan hyaluronic acid at 6 months, with a small but significant advantage on the pain scale, and no difference at1 to 2 months or at 12 months. That is the same shape as the knee, with the peak around 6 months, and it isthe honest description of what a patient should expect. A good response in the hip is real, arrives at 3 to 6months, and has narrowed by a year.

Send your hip X-ray report on WhatsApp and a doctor will tell you whether your stage of disease matchesthe patients in these trials.

Where the hip evidence is weaker than the knee

The comparison that flatters PRP least is the one against hyaluronic acid over a year. The 2022 meta-analysisin Arthroscopy pooled 6 randomised trials, 5 of them Level I, covering 211 patients injected with PRP and 197with hyaluronic acid, with a mean follow up of about 12 months. It found no significant difference in theimprovement of any outcome score, WOMAC, pain or Harris Hip Score, between the two. Read alongsideNICE’s position that hyaluronic acid should not be offered, with potential harm noted in the hip, matching itover a year is not a strong claim.

There is no placebo-controlled trial of PRP for hip osteoarthritis of the size or quality of the knee trials, whichis the largest gap in the evidence. The knee has a 288-patient trial in JAMA that was negative and a 610-patient trial that was positive to 5 years. The hip has neither, and the 5 randomised trials in the Cureus reviewwere mostly comparisons with hyaluronic acid. The right summary is that PRP appears to help some patientswith hip osteoarthritis for around 6 months, that it appears safe, and that nobody has yet shown it beats aneedle and saline in this joint.

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What else the hip evidence tells you to avoid

Three things follow from the trials and the guideline, and each argues against something commonly sold. Donot have hyaluronic acid in the hip, alone or mixed with PRP. NICE advises against it, and the 2025 meta-analysis in Frontiers in Bioengineering and Biotechnology of 190 patients found that adding hyaluronic acid toPRP produced significantly higher pain scores at 3 and 12 months than PRP alone, with no functional benefit. Aclinic offering a PRP and hyaluronic acid combination for the hip is offering a mixture the evidence says isworse than one of its parts.

Do not accept a course of 3 as the default, since a single injection outperformed multiple in the hip trials. Donot accept a leukocyte-rich product without a reason, since leukocyte-poor outperformed it. And do notaccept an unguided injection, whatever it costs, because the hip is the joint where a needle placed by feel ismost likely to miss and most likely to find something it should not. Steroid remains an option for a shortwindow, with NICE putting its relief at 2 to 10 weeks, and it is a reasonable way to confirm the joint is thesource of pain before anything else is injected.

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Five questions before any hip joint injection

Take these to whichever clinic you see, including ours.

• Is the pain from the joint or the gluteal tendons, and has that been confirmed on X-ray or ultrasoundrather than assumed.

• Will the injection be ultrasound guided, and how often does this clinician inject hips.

• Is the PRP leukocyte-poor, and is a single injection being offered rather than a course of 3.

• Is hyaluronic acid being added, and if so, why, given NICE and the 2025 meta-analysis.

• What stage is the arthritis, and if it is advanced, why is an injection being offered rather than a surgicalopinion.

Our doctors put it this way. PRP for hip arthritis is a reasonable single, guided, leukocyte-poor injection foran early to moderate joint. It is not a course of 3, not a mixture with gel, and not a treatment for a hip thatneeds a surgeon.

Message us on WhatsApp with where the pain is, your X-ray findings if known, and what you have tried, and adoctor will give you a straight answer.

What PRP does not do for the hip

PRP does not regrow cartilage in the hip, does not correct the shape problems such as impingement ordysplasia that cause much hip arthritis in younger people, and does not outperform hyaluronic acid over a yearin the pooled evidence. It has no placebo-controlled trial in this joint of the size that exists for the knee. Inadvanced disease, with a stiff joint, night pain and a narrowed X-ray, the treatment with the long track recordis hip replacement, which has among the best outcomes of any operation, and a surgeon rather than aninjection clinic is the right destination. PRP is not routinely commissioned by the NHS for hip osteoarthritis andprivate medical insurance rarely covers it.

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What hip injections cost in London, and what the trials say you should notpay for

Specialist central London clinics commonly charge from around £780 to £900 or more per image guided jointPRP injection including assessment, with a course of 2 to 3 taking a plan past £2,000. Image guided steroidinjections in central London are commonly quoted between £250 and £475. Outside central London PRP isadvertised from around £250 to £500, often unguided, which for the hip is a reason to decline rather than asaving.

The reframing comes from the hip trials themselves. A single guided leukocyte-poor injection did better than acourse of multiple. A clinic selling a course of 3 for the hip is selling 2 injections the evidence says you do notneed, at a cost that would fund the imaging, the physiotherapy and the surgical opinion that an arthritic hipactually requires. The right purchase for the hip is one injection, done properly, after a diagnosis.

Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship central London rates,with your exact figure confirmed at the free suitability review once a doctor has confirmed the joint is thesource and the stage is one the evidence supports treating.

Ask about the cost for your hip on WhatsApp and we will explain what the review covers.

The free suitability review

Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registereddoctor assesses you, confirms whether the pain is the joint or the tendons, reviews your imaging, and givesone of two answers. Either you are approved for treatment, with a single guided injection, a stated preparationand realistic expectations for around 6 months of benefit, or you are not approved, with an honest explanationof what would serve you better, whether that is physiotherapy, a steroid injection to confirm the diagnosis, or ahip surgeon.

We decline a meaningful share of the people who enquire. For hip osteoarthritis that share is higher than theknee, because the evidence is thinner and advanced hips belong with a surgeon.

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Why people choose The London PRP Clinic by The Wellness

• An 87 percent patient success rate across treatments.

• More than 187 five star reviews.

• Every treatment performed by a GMC-registered doctor.

• 100 supervised treatments completed by every clinician before they treat a patient here unsupervised.

• A 32 percent average density increase reported in our hair restoration programme.
  
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Frequently asked questions

Does PRP work for hip arthritis

Across 5 randomised trials every one reported pain and function improvement with no major adverse events,peaking around 6 months. Across 6 trials against hyaluronic acid there was no difference over a year, andthere is no large placebo-controlled trial in the hip. It is a reasonable option for early to moderate disease, nota proven one.

How many PRP injections do you need for hip arthritis

One. In the hip trials a single injection outperformed a course of multiple injections, and leukocyte-poor PRPoutperformed leukocyte-rich. A clinic proposing a course of 3 for the hip should be asked which trial supportsit.

Is PRP better than hyaluronic acid for the hip

Not over a year. A 2022 meta-analysis of 6 trials found no difference on any score at around 12 months, and a2023 meta-analysis found a PRP advantage at 6 months only. NICE advises against hyaluronic acid in any jointand notes potential harm in the hip, so matching it is not a strong claim.

Can PRP be combined with hyaluronic acid for hip arthritis

It should not be. A 2025 meta-analysis of 190 patients found adding hyaluronic acid to PRP producedsignificantly worse pain scores at 3 and 12 months than PRP alone, with no functional benefit, and NICEadvises against hyaluronic acid in the hip altogether.

Is PRP for the hip safe

The 5 randomised trials reported no major adverse events. The hip joint sits close to the femoral vessels andnerve, so the injection should always be ultrasound guided by someone who injects hips regularly. Anunguided hip injection should be declined whatever it costs.

When should I see a hip surgeon instead

When the joint is stiff with a shrinking range of movement, when pain wakes you at night or is present at rest,when the X-ray shows advanced narrowing, or when walking distance has fallen despite physiotherapy. Hipreplacement has among the best outcomes of any operation, and an injection clinic is the wrong place for thathip.

message us on WhatsApp or email team@thewellnesslondon.com

References

• Cureus, 2024. Almutairi and Alazzeh. Efficacy and safety of PRP intra-articular injections in hiposteoarthritis, a systematic review of randomised clinical trials.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578636/

• Arthroscopy, 2022. Belk et al. Platelet-rich plasma versus hyaluronic acid for hip osteoarthritis yieldssimilarly beneficial short-term clinical outcomes, a systematic review and meta-analysis of 6 randomisedtrials. https://pubmed.ncbi.nlm.nih.gov/34785294/

• Cureus, 2023. Comparing intra-articular platelet-rich plasma with hyaluronic acid for the treatment of hiposteoarthritis, a systematic review and meta-analysis of 7 trials and 478 participants.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613513/

• Frontiers in Bioengineering and Biotechnology, 2025. Platelet-rich plasma with versus without hyaluronicacid for hip osteoarthritis, a systematic review and meta-analysis of 190 patients.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980421/

• NICE, 2022. Osteoarthritis in over 16s, diagnosis and management, guideline NG226.https://www.nice.org.uk/guidance/ng226/chapter/Recommendations

• Australasian Journal of Ultrasound in Medicine, 2024. Oo et al. Comparison of ultrasound guidance withlandmark guidance for symptomatic benefits in knee, hip and hand osteoarthritis.https://pmc.ncbi.nlm.nih.gov/articles/PMC11109994/

• JAMA, 2021. Bennell et al. Effect of intra-articular platelet-rich plasma vs placebo injection on pain andmedial tibial cartilage volume in patients with knee osteoarthritis, the RESTORE randomised clinical trial.https://pubmed.ncbi.nlm.nih.gov/34812863/

• Knee Surgery, Sports Traumatology, Arthroscopy, 2022. Long-term clinical efficacy of pure platelet-richplasma versus sham saline in knee osteoarthritis, a multicentre double-blind randomised trial of 610participants. https://delosportsmedicine.com/wp-content/uploads/2022/03/PRPLongTermEfficacyArticle.pdf

• Central London clinic price lists for image guided PRP and steroid injections, accessed September 2026.

This article is for general information and does not replace a medical assessment. Speak to one of our doctorsbefore deciding whether PRP is right for your hip.