Bone Marrow Aspirate Concentrate With Hip Arthroscopy in a Heterogenous Group of Patients May Result in Improved Patient-Reported Outcomes: A Systematic Review

Abstract

Introduction:

There is little literature reporting on the efficacy of bone marrow aspirate concentrate (BMAC) in conjunction with hip arthroscopy.

Purpose:

We sought to systematically review the literature on BMAC use following hip arthroscopy, in particular, whether its use results in improved patient-reported outcome measures (PROMs).

Methods:

The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed when querying PubMed, Cochrane Central Register of Controlled Trials, and Scopus in January 2023. Articles were included if they reported on pre- and postoperative outcomes for patients undergoing hip arthroscopy with concomitant BMAC and were written in English.

Results:

Five articles were included in the review. A total of 252 hips undergoing BMAC and hip arthroscopy performed between 2010 and 2020 were evaluated. The average age of patients in the studies ranged between 32.8 and 48.5 years. All studies reported improved postoperative PROM scores compared to preoperative outcome scores after BMAC and hip arthroscopy. Two studies reported survivorship of 100% and 85.7%. All 5 studies conducted a subanalysis between BMAC and hip arthroscopy and a control group. Three studies reported superior outcomes in the BMAC and hip arthroscopy group, while another study reported findings that trended toward favoring the BMAC and hip arthroscopy group but that did not reach statistical significance.

Conclusion:

BMAC may improve outcomes in patients undergoing hip arthroscopy. However, due to the small sample size and lack of standardized control groups, the results of this systematic review are inconclusive.

Plain Language Summary

Outcomes of Hip Arthroscopy With Bone Marrow Aspirate Concentrate Injection

This study reported on findings of previously published literature reporting on the effects of bone marrow aspirate concentrate injection in patients undergoing hip arthroscopy. Why was this study done? Multiple studies have been published reporting on outcomes after bone marrow aspirate concentrate (BMAC) and hip arthroscopy. However, results are mixed with some studies reporting benefit to having BMAC and hip arthroscopy, while other studies mention its benefit only in specific patient populations. This study was done to provide an overview of published literature. What did the researchers do? The researchers systematically searched through three online databases to find studies that reported patient reported outcome measures (PROMS) in patients undergoing hip arthroscopy and BMAC. They also conducted a sub analysis to see whether hip arthroscopy and BMAC resulted in improved outcomes when compared to patients undergoing traditional hip arthroscopy procedures without BMAC. What did the researchers find? The researchers found five studies that reported on the outcomes of patients undergoing hip arthroscopy and BMAC. All five studies reported patients experienced improvement between PROMS before and after hip arthroscopy and BMAC. Two studies reported low rates of conversion to total hip arthroplasty. Three studies compared hip arthroscopy and BMAC to hip arthroscopy without BMAC and found that the hip arthroscopy and BMAC group had better outcomes. What do the findings mean? This study’s findings show that hip arthroscopy and BMAC may be beneficial in indicated patient populations. It highlights the potential for BMAC when treating cartilage defects of the hip and provides preliminary data that encourages further comparative analysis between BMAC and other orthobiologics in treating intra-articular hip pathology.