Platelet Rich Plasma Combined with Arthroscopic Surgery Versus Arthroscopic Surgery Alone for the Treatment of Femoroacetabular Impingement Syndrome

Background/Objectives: In patients with femoroacetabular impingement syndrome (FAI), the efficacy and safety of platelet-rich plasma (PRP) as an auxiliary treatment for femoroacetabular impingement syndrome (FAI) remain controversial. The study aimed to evaluate the safety and clinical effectiveness of arthroscopy combined with PRP compared with arthroscopy alone for the treatment of patients with FAI. Methods: In this retrospective study, patients who underwent hip arthroscopy for the treatment of FAI between January 2019 and January 2022 were included and divided into two groups: (1) arthroscopy group (A) and (2) arthroscopy combined with PRP group (AP). During the 2-year follow-up, Visual Analog Scale (VAS) pain scores, modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (iHOT-12), Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sport-Specific (HOS-SSS), 12-Item Short Form Physical Composite Summary and Mental Composite Summary (SF-12 PCS and MCS), medical related expenses were recorded. Minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) comparison for mHHS, HOS-ADL, and HOS-SSS scores between the two groups. VAS, mHHS, iHOT-12, HOS-ADL, HOS-SSS score, and changing trends were described pre-operation and one month, six months, one year, and two years after the operation. Results: A total of 107 FAI patients were included; 55 patients were in Group A, 52 patients in Group AP. The overall mean ± SD was 39.1 ± 12.6 years (arthroscopy group, (A): 18 females, arthroscopy combined with PRP group, (AP): 13 females). There were no significant differences in the general data between the two groups (p > 0.05). Except for the auxiliary tools subscale of the mHHS (p > 0.05), both groups showed statistically significant improvements at one year (p < 0.01) and two years (p < 0.01) after surgery than pre-operation in VAS, mHHS, iHOT-12, HOS-ADL, and HOS-SSS. The scores after two years of treatment were further improved compared with one year (p < 0.01). There were no differences between the two groups at one year and two years postoperatively in VAS, mHHS, iHOT-12, HOS-ADL, and HOS-SSS scores (p > 0.05). No differences in the achievement of MCID and PASS for mHHS, HOS-ADL, and HOS-SSS (p > 0.05). A significant difference in SF-12 PCS and MCS was observed between the two groups preoperatively and two years after the operation (p < 0.01). The Group AP had significantly higher scores at two years (p < 0.01) after surgery than the Group A in the SF-12 MCS. There was no significant difference in SF-12 MCS distribution (>46.5, 36–46.5, ≤36) (χ2 = 0.198, p > 0.01). The AP group had significantly higher indirect and absenteeism expenses in the year of surgery than Group A (p < 0.01). Conclusions: For patients with FAI, compared with arthroscopy alone, arthroscopy combined with PRP can significantly improve SF-12 MCS two years after therapy; however, there was no significant improvement in clinical results, and indirect treatment costs were higher. Arthroscopy combined with PRP has no obvious advantage and cannot be recommended as the first choice.