PRP is NOT Recommended for Femoroacetabular Impingement
Based on the highest quality evidence, platelet-rich plasma (PRP) should not be used as an adjunctive treatment for femoroacetabular impingement (FAI) of the hip, as it provides no clinically meaningful improvement in pain or functional outcomes while increasing treatment costs.
Evidence Against PRP for FAI
The most recent and highest quality study—a 2026 retrospective comparative study of 107 FAI patients—found that arthroscopy combined with PRP showed no significant improvement in clinical outcomes compared to arthroscopy alone 1. While both groups improved postoperatively, there were no differences between groups at 1 or 2 years in:
- VAS pain scores
- Modified Harris Hip Scores (mHHS)
- International Hip Outcome Tool-12 (iHOT-12)
- Hip Outcome Score subscales (HOS-ADL, HOS-SSS)
- Achievement of minimal clinically important difference (MCID)
- Patient-acceptable symptom state (PASS)
The only difference favoring PRP was a modest improvement in SF-12 Mental Composite Summary scores at 2 years, but this came at significantly higher indirect costs and absenteeism expenses 1.
Consistent Negative Findings Across Multiple Studies
This conclusion is reinforced by multiple high-quality studies:
A 2021 prospective randomized controlled trial (n=113) found no significant difference in iHOT12 scores or other patient-reported outcomes at 2-year minimum follow-up between PRP and placebo groups 2
A 2023 retrospective study (n=345) demonstrated no differences in pain scores or patient-reported outcomes at any time point when PRP was injected onto the capsule at closure 3
A 2022 systematic review concluded that low-quality evidence indicates PRP is not associated with improved outcomes following hip FAI surgery (mean difference -1.42,95% CI -3.95 to 1.11, P = .27) 4
A 2020 systematic review of 363 hips found that PRP did not lead to significantly improved postoperative pain or functional outcomes compared to control groups 5
Guideline Context
The AAOS/NIH consensus recommendations emphasize that biologics like PRP have greatly outpaced the evidence in clinical use 6. The International Society on Thrombosis and Haemostasis guidance states "it is uncertain whether PRP can be used to treat osteoarthritis" and notes that clinical preparations are poorly standardized 7.
Clinical Bottom Line
For FAI treated with hip arthroscopy:
- Do not add PRP as an adjunctive treatment
- PRP provides no benefit for pain relief or functional improvement
- PRP increases treatment costs without improving morbidity or quality of life
- Standard arthroscopic treatment alone is the appropriate approach
Important Caveat
While PRP shows no benefit for FAI, recent evidence suggests it may have utility for extra-articular hip pathology such as greater trochanteric pain syndrome and acute hamstring injuries 8. Do not extrapolate FAI evidence to these distinct conditions.