Mic'd Up with ChiroUp: A Chiropractic Podcast

Broken to Better: A Hip Pain Case that Reinvented Our Approach


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In this episode of Mic’d Up with ChiroUp, we unpack a real-life case that hits close to home for anyone in musculoskeletal care: a 50-year-old patient with stubborn hip pain who’s caught between failed conservative care and an unwanted surgery.

You’ll hear how we navigated that clinical crossroads—what didn’t work, what finally did, and how PRP injections and regenerative medicine opened a new door.

We also dig into how chiropractors can lead within a collaborative care model, and how technology—specifically a smarter EHR—can actually enhance evidence-based practice.

Sources:

Almutairi AN, et al. (2024). PRP vs standard care in hip OA – RCT Systematic Review: PRP injections led to significant pain and functional improvement in hip OA patients, with no major adverse events, outperforming hyaluronic acid.

Nouri F, et al. (2022). PRP vs Hyaluronic Acid RCT: PRP provided longer-lasting (6+ months) pain relief and better hip function than HA in grade 2–3 hip OA. Adding HA to PRP did not significantly enhance results.

Pereira TV, et al. (2025). Network Meta-analysis of Injections: In knee/hip OA, biologic injections (PRP ± HA) demonstrated the most sustained pain and function improvements up to 12 months, compared to corticosteroids or placebo.

Xu C, et al. (2022). Long-term Follow-up in Knee OA: PRP-treated patients had higher 6-year survival from surgery (90% vs 74%) and greater satisfaction than those treated with HA, suggesting disease-modifying potential.

Giorgino R, et al. (2024). Systematic Review – MSC Therapy in Hip OA: Intra-articular MSC injections showed pain relief, functional gains, and imaging signs of cartilage repair with minimal adverse events, though higher-quality trials are needed.

Entessari M, et al. (2023). Review – Stem Cells in Hip OA: 5 of 6 studies reported significant improvement post-MSC injection; no major complications noted, underscoring a positive safety and efficacy trend in early clinical experience.

OARSI/Guidelines Synthesis (2022): High-quality guidelines thus far have recommended against PRP or stem cell injections in hip OA due to insufficient evidence, but more recent research and some regional guidelines are neutral or cautiously optimistic, reflecting evolving evidence.

Post-injection Rehab Principles: (Physiopedia, 2023) Contraindications for PRP include immunosuppression and active infection; and (Clinical consensus) gradual rehabilitation after PRP/MSC is essential to protect healing tissue while restoring function.

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Mic'd Up with ChiroUp: A Chiropractic PodcastBy Dr. Brandon Steele & Dr. Tim Bertelsman

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