Platelet-rich Plasma vs. Whole Blood for Gluteus Medius Tendinopathy

Ultrasound-Guided Platelet Rich Plasma Versus Whole Blood Injection for the Treatment of Gluteus Medius Tendinopathy: A Double-Blind Randomized Controlled Study

Gluteus medius tendinopathy, which is often referred to as Greater Trochanteric Pain Syndrome, is characterized by pain in the lateral aspect of the hip that is aggravated by side lying, stair climbing, and walking. Treatment is currently limited to lifestyle modifications, corticosteroid injections, physical therapy, and open and endoscopic surgical repair. Platelet rich plasma (PRP) injections contain important growth factors that are essential in the healing and tissue formation processes. However, the extent to which PRP is more efficacious than whole blood in tendinopathy remains unclear. In this double-blind randomized trial, patients will be allocated to receive either a PRP or whole-blood injection. Post-procedure assessments will occur at 6 weeks, 3 months, 6 months, 9 months, and 1 year.

Inclusion Criteria:

• Moderate to severe lateral hip pain for greater than 3 months
• Symptoms are refractory to conservative treatment, including at least 8 weeks of traditional physical therapy for this condition
• Moderate to severe gluteus medius tendinosis with or without partial tear <1 cm
• Normal neurologic exam except for hip abductor weakness on the affected side

Exclusion Criteria:

• Severe (Tonnis grade >1) hip osteoarthritis with active synovitis or bone edema
• Active lumbar radiculopathy with pain, numbness or weakness in a dermatomal distribution
• No evidence of fatty atrophy, denervation, or complete tears of gluteus medius seen on MRI
• Any condition that requires anti-platelet or anti-coagulation therapy, including aspirin therapy for cardiac conditions
• Non-English speaking