Corticosteroid plus hyaluronic acid hip injection combined with physiotherapy for mild hip conditions.

Intra-articular Corticosteroid With Hyaluronic Acid Plus Physiotherapy for Hip Pathologies (NON-OP HIP) - a Randomized Controlled Trial

This will test whether a combined corticosteroid and hyaluronic acid hip injection plus physiotherapy helps people aged 40–60 with mild hip osteoarthritis, labral tears, or femoroacetabular impingement reduce pain and move better.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 100 (estimated)
• Ages: 40 Years to 60 Years
• Sex: All
• Sponsor: ArthroBiologix Inc. (Industry-sponsored)
• Locations: 1 site (Hamilton, Ontario)
• Trial ID: NCT06653985 on ClinicalTrials.gov

What this trial studies

This interventional program enrolls people 40–60 years old with mild hip arthritis (Kellgren-Lawrence grade 2 or lower) and/or labral tear or femoroacetabular impingement who get >50% pain relief from an ultrasound-guided diagnostic anesthetic injection. Enrolled participants receive an ultrasound-guided intra-articular injection combining a corticosteroid and hyaluronic acid followed by a course of physiotherapy paid for by the participant. Key exclusions include moderate-to-severe arthritis, osteonecrosis, prior hip or pelvic surgery or fracture, connective tissue disorders, chronic low back pain with sciatica, or a recent hip steroid injection. The intervention is offered at a single private center (ArthroBiologix) in Hamilton, Ontario, and outcomes will focus on pain and function over the months following treatment.

Who should consider this trial

Good fit: Ideal candidates are 40–60 years old with mild hip arthritis or compatible labral/FAI pathology who get more than 50% pain relief from a diagnostic intra-articular anesthetic injection and can arrange subsidized private physiotherapy.

Not a fit: Patients with moderate-to-severe arthritis (Kellgren-Lawrence grade 3+), osteonecrosis, prior hip surgery or fractures, hypermobility/connective tissue disorders, chronic low back pain with sciatica, or a recent intra-articular steroid injection are unlikely to benefit from this approach.

Why it matters

Potential benefit: If successful, this approach could provide faster pain relief with longer-lasting improvement and help delay or avoid hip surgery for people with mild hip disease.

How similar studies have performed: Previous work shows corticosteroids give rapid but short-term relief and hyaluronic acid can have a slower onset with longer benefit, but combining the two has limited and mixed evidence compared with each treatment alone.

Eligibility criteria

Inclusion Criteria:

1. Patients aged 40-60 years old.
2. Patients with mild hip arthritis (Kellgren-Lawrence grade 2 or lower) with or without a labral tear and/or femoroacetabular impingement and/or mild hip dysplasia.
3. Patients who demonstrate more than 50% reduction in hip pain following a diagnostic injection (ultrasound guided intra-articular anaesthetic only).
4. Able to subsidize private physiotherapy services.
5. Able to provide informed consent.

Exclusion Criteria:

1. Active infection
2. Osteonecrosis of the hip, moderate to severe arthritis (Kellgren-Lawrence grade 3 or higher), or moderate-to-severe hip dysplasia
3. Previous hip fracture, pelvic fracture, or lower limb fracture,
4. Previous surgery to the pelvis, hip or lower limb
5. Hypermobility disorder or connective tissue disease (e.g. Ehler's-Danlos syndrome, Marfan's syndrome etc.)
6. Patients with chronic low back pain and/or sciatica
7. Patients who received an intra-articular steroid hip injection within 3 months
8. Patients who have previously received a hyaluronic acid injection
9. Injuries sustained in a motor vehicle collision.
10. Injuries sustained in the workplace and have a worker's compensation claim.
11. Injuries resulting in a medico-legal dispute.
12. Patients who are pregnant of planning to become pregnant
13. Currently enrolled in a study that does not permit co-enrollment
14. Unable to obtain informed consent
15. Unable to comply with the study protocol
16. Contraindication to corticosteroid or hyaluronic acid injection
17. Prior enrollment in the study.

Where this trial is running

Hamilton, Ontario

• ArthroBiologix — Hamilton, Ontario, Canada (Recruiting)

Study contacts

• Study coordinator: Steven Phillips

Conditions Osteoarthritis; Femoroacetabular Impingement Syndrome; Labrum Injury of the Hip Joint; Hip; Femoroacetabular impingement; Labral tear; Hyaluronic acid; Corticosteroid