Rethinking Hip Injections: Corticosteroids, HA, and PRP No Better than Saline .

Hip osteoarthritis continues to drive interest in intra-articular injections as a way to delay or avoid total hip replacement, but high-quality evidence remains limited. In a network meta-analysis of 11 RCTs (1353 patients), Gazendam and colleagues found a sobering result: no injectable—corticosteroid, hyaluronic acid, PRP, or PRP+HA—outperformed placebo saline for pain or function at 2–4 or 6 months. In fact, saline itself produced clinically important improvements, highlighting the powerful placebo effect and the need for larger, comparative trials. Until then, the evidence suggests no clear advantage of any hip injection over placebo, and routine use should be approached with caution given cost, invasiveness, and infection risk.