Intraosseous Bone Marrow Concentrate for Hip Osteoarthritis: A Case Series

Hip osteoarthritis (OA) is a prevalent cause of pain and disability in the US, with continued progression often necessitating total hip replacement surgery. However, postoperative complications and persistent pain can occur, compelling the need for alternative long-term management strategies. Advances in orthobiologics, such as bone marrow concentrate (BMC) injections, offer a non-surgical alternative for hip OA treatment that can facilitate pain management and disease modification. Recent case studies show significant improvement in pain, function, and quality of life following intra-articular BMC injections, but there is limited literature on the effect of intraosseous (IO) orthobiologic injections for hip OA. We hope to provide insight into this topic of IO BMC injections under fluoroscopic guidance for hip OA with our case series that followed four males and one female with an average age of 67.6 years and a Tonnis score of 2. Primary outcomes included change in the visual analog scale (VAS) pain score and subjective functional improvement using the single-assessment numeric evaluation score. Secondary outcomes studied included adverse events and safety. Despite varying follow-up durations, all patients experienced greater than 50% improvement in function, with the average pain reduction on VAS from 7.6 to 2.4. No adverse effects were reported. IO BMC injections appear safe and effective for hip OA. Further investigation is warranted, including randomized controlled trials with larger samples and consistent follow-ups to validate these findings and assess long-term efficacy through follow-up imaging.