Subchondral Bone Marrow Edema in the Hip: PRP Injection Treatment

Specialists in Treating Subchondral Bone Marrow Edema of the Hip with PRP Injections

I am Miguel Alfonso Porcar recognized specialist in the treatment of hip bone edema with rest and non-steroidal analgesics.

In more severe cases of hip bone edema that do not respond to more conservative treatments, we use bioregenerative platelet-rich plasma therapies.

At Regenerat Traumatology Clinic we are specialists in the diagnosis and treatment of the main hip ailments and injuries.

Our goal is to determine the cause of your hip pain, perform diagnostic tests to determine the extent of your hip pain or injury.

Once the diagnosis is made, we will apply the most appropriate regenerative traumatology treatment to relieve your pain and help you recover your well-being as soon as possible.

What is bone edema of the hip?

Hip pain is a common ailment that can affect people of all ages.

Bone edema occurs when the medullary zone of the bone, i.e. the trabecular or spongy tissue, suffers inflammation or injury.

Bone edema is the accumulation of fluid in the bone that causes swelling in the bone marrow.

Bone marrow is thespongy tissue in the center of bones.

The bone has blood vessels which, in the event of trauma, can cause internal bleeding. If the inflammatory fluid is not reabsorbed and persists over time, it can lead to osteonecrosis.

The anatomical areas and bones most prone to bone edema are the hip, knee, talus and calcaneus (foot and ankle bone edema), tibia, shoulder and wrist.

What is subchondral bone edema?

A subchondral edema is an inflammation or injury that occurs in the medullary zone of the bone, specifically under the cartilage, just below the joints.

This type of edema is characterized by localized pain in the affected area, which intensifies with activity and decreases with rest.

It may manifest with joint effusion, soft tissue edema, lameness and limited joint mobility.

Causes of bone edema of the hip

• Bone edema of the hip is often related to osteoarthritis, often referred to as “wear and tear” arthritis. These are cartilage lesions in which the cartilage breaks down and the joints become painful.
• It may be due to fracture, joint injury, trauma or acute bone overload. They are the main cause of hip bone edema.
• A bone infection (osteomyelitis) sometimes causes fluid accumulation.

Osteoarthritis

If you have osteoarthritis, bone edema may be a sign that your disease has worsened and you may have developed subchondral cysts.

These cysts occur in places where the cartilage is damaged. The cartilage hardens and forms fluid-filled sacs (cysts) in the joint. The cysts take up space in the joint, making it narrower, which further wears down the cartilage until eventually, the bone rubs against the bone.

As you lose more and more cartilage, the nerves become exposed. You may feel more pain and have less range of motion. This is especially true in cases of osteoarthritis of the hip.

If the hips are not properly aligned, the condition can worsen. Misalignment puts pressure on a joint that is already inflamed.

Compared to people without edema, those with hip bone edema are more likely to have more severe osteoarthritis symptoms and to worsen more rapidly, typically within 15 to 30 months.

Bone edema of the hip due to injury

Bone marrow edema may occur with fractures and other serious bone or joint injuries. This is especially true when the injury affects the hip.

After an injury, different types of fluid can accumulate in a bone; blood, or fluids released by fibrosis (scar tissue) or necrosis (tissue death).

Bone hematoma, trabecular fracture, subchondral stress fractures and injuries, intraosseous edema or bone contusions are terms that have been used interchangeably to describe the traumatic origin of these injuries.

Bone injuries caused by a direct blow, applied shear forces, by the impact of several bones against each other, or by tensile forces in the context of an avulsion injury may result in a bone hematoma.

Other causes of bone marrow edema

• Stress fracture of the hip due to repeated impact and stress on a weight-bearing joint.
• Bone tumors, in which the fluid weakens the bone and increases the risk of fracture.
• Bone infection (osteomyelitis).

Symptoms of bone edema

Pain is the main symptom of bone edema and is localized in the affected area.

• This pain usually increases with physical activity and decreases with rest.
• If bone edema persists, pain may manifest itself even during night rest.
• Sometimes, joint effusion and soft tissue edema may occur.
• Depending on the location of the bone edema, you may experience lameness and a reduction in joint range of motion.

Causes of Hip Pain Treatable by a Hip Specialist

The primary cause of acute hip pain is often a fracture of the femoral neck.

Hip fractures are particularly common in the elderly population due to underlying conditions such as osteopenia and/or osteoporosis

Other causes and treatments for hip pain:

• Gluteal tendinopathy injections: For overuse injury of the hip tendons that are activated when we walk, stand and transfer weight from one leg to the other during walking.
• Hip bursitis injection treatment: A procedure to address inflammation of one or more bursae in the hip. Bursae are small, fluid-filled sacs located between bones and soft tissues, such as tendons or muscles, that act as cushions to reduce friction.
• Trochanteric bursa injection: A treatment for inflammation of the bursa that cushions the greater trochanter bone of the hip. This condition typically causes pain in the lateral region of the hip
• Hyaluronic acid injection for arthritis: Osteoarthritis, a degenerative joint disease, is more common in the elderly. In this condition, the cartilage within the joint gradually wears away, leading to pain, swelling, stiffness, and restricted movement in the affected area.
• Bone marrow edema of the hip: A condition characterized by increased interstitial fluid within the bone marrow, typically in the femur. It can result from inflammation or injury in the medullary area (inside the bone) of the hip, often due to trauma, overuse, or underlying conditions