Procedures · Hip arthritis · Glastonbury, CT
Hip pain does not always mean a hip replacement. Dr. Paul Tortland, DO, has offered PRP since 2007, bone marrow aspirate (BMA) since 2008 and microfragmented adipose tissue (MFAT) since 2009. Patients from across New England come to learn whether their hip can be treated without surgery, and when replacement is the right call.
Most hip arthritis can be treated without surgery first, using strengthening and, when needed, ultrasound-guided PRP, bone marrow aspirate (BMA) or microfragmented adipose tissue (MFAT). Hip replacement is the right choice for end-stage, bone-on-bone hips, and Dr. Tortland will tell you directly when that is your situation.
The right choice depends on how much joint space remains and what your imaging shows.
| Consideration | PRP | BMA or MFAT | Hip replacement |
|---|---|---|---|
| Best fit | Mild to moderate arthritis, tendon and labral problems | Moderate to advanced arthritis with some joint space left | End-stage, bone-on-bone arthritis |
| What it does | Aims to support the joint's healing environment | Delivers your own cell-rich tissue into the joint | Replaces the damaged joint with an implant |
| Time to benefit | About 4 to 12 weeks | About 3 to 6 months | Months of recovery and rehabilitation |
| Main limit | Results vary and it does not rebuild lost joint space | More involved procedure; results vary | Major surgery with longer recovery and surgical risks |
| Pricing | Custom-concentrate, high-dose PRP (not just PRP) from $1,800, pending a full diagnostic workup, if recommended by Dr. Tortland | Tailored to each patient's treatment protocol. Treatments are not cookie-cutter or one-size-fits-all. | Set by the surgical practice and your plan |
The $500 evaluation is unhurried and includes film review, a physical exam and diagnostic ultrasound when appropriate. Dr. Tortland looks for the true pain generator, which in the hip can be the joint, the labrum, the tendons or the spine. About 30 percent of his patients travel from outside Connecticut.
If a hip replacement is the better path, he says so directly and refers you to a trusted orthopedic surgeon. Seeing a non-surgical specialist first does not close off surgery.
Related reading: hip pain treatment, alternatives to hip replacement, cellular orthobiologics (BMA and MFAT) and PRP injections.
Often, for a time. Many hips respond to strengthening and, when needed, PRP, BMA or MFAT. End-stage, bone-on-bone hips usually need replacement, and Dr. Tortland will tell you which describes your hip.
PRP usually fits earlier arthritis and tendon or labral problems. BMA or MFAT are usually considered for moderate to advanced arthritis. He decides after reviewing your imaging.
Most patients notice gradual improvement between 6 and 16 weeks. PRP usually shows benefit in about 4 to 12 weeks, and BMA or MFAT in about 3 to 6 months.
In most cases, start with a non-surgical specialist. A thorough evaluation makes sure surgery is recommended only when it is truly necessary.
Bring your hip MRI from the last year, on disc or a link that does not expire, plus the report and any x-rays.
Mulvaney SW, Tortland PD, Shiple B, Curtis K. Regenerative medicine options for chronic musculoskeletal conditions: a review of the literature. Endurance and Sports Medicine. 2018.
Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. Int J Mol Sci. 2020;21(20):7794.
Candidacy is determined on ultrasound, not over the phone. Bring your imaging and get a straight answer about your joint in one visit.