I also have a labral tear (hip) and have looked into it. Luckily, mine doesn't bother me too much these days. I have heard many positive things about stem cell injections for the tear, though not so positive about PRP.

There's a couple FB groups out there for labral tear people, one specifically for runners that has some crossover with triathletes and other athletes as well. Check it out and read through some of the posts, might be helpful.

We know that there is some weak anecdotal evidence, but actual research shows there is insufficient data to say anything: https://www.cochrane.org/...soft-tissue-injuries

Anyone selling PRP who says otherwise is scamming you.

I had two labral reconstructions last year, both with stem cell therapy. Stem cells were used due to arthritis (not detected in MRI). While I now have cadaver labrums, I still have hip pain - likely due to arthritis. So did the stem cells help my pain? No, not really.

I had PRP on a small tear in 2017. The result was very good (3 weeks later I was running pain free). I did have a very good hip socket with no other issues, and only a small tear.

---

---

"Only those who risk going too far can possibly find out how far one can go." T.S. Elliot | Cycle2Tri.com
Sponsors: SciCon | | Every Man Jack

Were you havin a tough time with just walking before your hip prp? I hear a lot of people have a general pain that hurts when they're weighted. I don't really have that problem. At least not since I rebalanced by muscles and got my glutes and hams to engage while walking and running. My situation is I can do just about anything without pain, but when I put my socks on the hips kinda pop or even clunk I'd say. I do not like it!

No, I did have pain after running for a few hours, but in most of the day to day stuff, I felt nothing. I had no other issues (popping, clicking, etc), just intense pain when I ran.

---

---

"Only those who risk going too far can possibly find out how far one can go." T.S. Elliot | Cycle2Tri.com
Sponsors: SciCon | | Every Man Jack

PRP is promising, but nowhere near standard of care yet. Nonetheless a PRP injection is much easier to try than a hip operation. If you are going to have any injection done the doc needs to use some form of image guidance to ensure that they're in the hip joint. I use either ultrasound or XR and both work fine.

---

Brian
“Eat and Drink, spin the legs and you’re going to effin push (today).” A Howe

My main questions are how much do the kits and machines used to harvest the prp affect the treatment. E.g. accelerated biologics used at UNC Chapel Hill claims a max 5x increase of platelets whereas the Arthrex Angel system used at Wake Baptist in Wake Forest, NC claims an up 18x increase. My other question would be what is the advantage to floroscopy when treating an injury such as a labral tear e.g. can that style of guidance place the prp nearer to the actual tear and therefore be more effective. Generally the docs at Duke, UNC and a place called EmergeOrtho in the Triangle area of NC all report anecdotally that prp helps about 60-65% of the time for hip issues, a lower efficacy than with knees for example. I've found that private clinics are generally adding "activators" to the PRP such as calcium chloride whereas the large and reputable hospitals of the area (and there are numerous) are not adding anything other than the anti-coagulant to the PRP. At this point I will probably go with Wake Baptist based on what I know about their havesting system, even though they do not use floroscopy. Do you have an opinion or any further guidance for me?

OK, so I'll chime in here and do my Slowtwitch civic duty. I'm a sports medicine orthopaedic surgeon with 35 years experience including being the attending orthopaedic surgeon for our local football team. I am also considered to be a world expert in biological treatment of knee conditions, including the intra-articular use of corticosteroids, hyaluronic acid, PRP, multipotential "stem cells" and pluripotential stem cells (true stem cells). I am a reviewer for two major journals and have been a co-reviewer on most of the recently published papers on the use of intra-articular stem cells (mostly used in the knee so far).
So the short of things for your labral tear is to avoid surgery if at all possible. Firstly, there are very few people skilled at arthroscopic labral repairs, and if you do go to the best (Marc Philipon), it will be expensive. The recovery is long to get back to distance running at the same level. I would try HA as a first go if your pain is in the 3-6/10 level. The best agent is Monovisc. The injection should be done under flouro control with a little contrast agent to confirm position of the needle.
PRP has been shown to be of benefit for the treatment of early osteoarthritis of the knee but there are no supporting papers for it's use in labral tears of the hip. Having said that, we still use it for treatment of that condition in our professional athletes. You want a small volume (4ml), leukocyte poor type of PRP. Arthrex's ACP would be fine and is a quick and simple type of PRP to use.
There is no supporting literature for the use of true stem cells in the treatment of labral tears of the hip. True stem cells are derived from embryonic sources (limited use under federal health laws) or are extracted from your bone marrow then induced and cultured along mesenchymal cell lines (also currently not permitted under federal health laws except for experimental exceptions). Most of the things marketed as stem cells and promoted online (centrifuged fat from your buttocks), are not true stem cells and furthermore, have no scientific evidence to support their use.
Good luck

How do you know your Labral tears need treating and are actually causing pain? MRIs don’t show pain. How do you know that you haven’t had these years for years asymptomatically? Find a good PT before causing irreversible damage by invading the joint with needles or something worse.

I hope you didn’t waste your money. If you can see the tear on MRI it makes sense logically why PRP would never work. It is a structural mechanical problem - how would you mechanically move the labrum together to heal? It makes no sense from all the studies I’ve done. I am today six weeks post op for cam and pincer and four anchors with a surgeon that trained under Byrd in Nashville. Philipon and Byrd are both the best but my recovery has been amazing. I have tried every single thing under the sun for the past 3 years and finally had enough. I am religious about PT but what bothered me was walking. I could still race at a fairly elite level (cyclist only)... because it’s not weight bearing. There was no arthritis in the joint. So the pain I had — was the tear and I finally caved. I miss training and I know it’s a long road. But you’ll k ow when it’s time either way to try spending more money on stuff -

I think the hip labral tear folks have to figure out what to do... if PT had kept me in check I would have not had surgery. There’s no way in heck I would try PRP for a labral tear. Knees sure - I can find no legitimate studies on hips with PRP.

I hear what you're saying but my friend knows a guy who said....