Nanosurgery and Bioengineered Regenerative Protocols for the Treatment of Hip Osteoarthritis: A Double-Blind Randomized Controlled Trial as an Alternative to Surgical Hip Replacement.

Hip osteoarthritis (HOA) significantly affects mobility and quality of life, with total hip arthroplasty (THA) being a common treatment. However, complications and increasing revision rates highlight the need for alternative approaches. This study evaluates the efficacy of ultrasound-guided nanosurgery and bioengineering treatment (NSBT) compared to non-standardized platelet-rich plasma (PRP) treatment for patients with symptomatic HOA. A double-blind, randomized trial included 38 patients referred for THA, divided into two groups. The study group received NSBT with modified PRP enriched with somatotropin and , while the control group received PRP and hyaluronic acid injections without a standardized protocol. Treatments were guided by ultrasound, and outcomes were assessed using the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Score (HHS), and range of motion (RoM) evaluations over 12 months. The study group showed significant improvements in all clinical outcomes, including reductions in VAS scores from 7.8 to 0.2 ( < 0.0001) and WOMAC scores from 76.2 to 10.5 ( < 0.0001). The HHS improved from 56.4 to 93.0, and RoM showed substantial gains in flexion, external rotation, and internal rotation (all < 0.001). The control group demonstrated less pronounced improvements. NSBT offers a safe and effective alternative for managing HOA, significantly reducing pain and improving joint function while potentially delaying or avoiding the need for THA. Further long-term studies are warranted to confirm these findings.