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May 27, 2026Journal of Experimental Orthopaedics0 citationsOpen Access

Combined ultrasound‐guided hyaluronic acid injections, high‐power laser therapy and physiotherapy improve hip function in osteoarthritis: A randomized controlled trial

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ASAlessandro de SireNMNicola MarottaIBIsabella Bartalotta

Key Points

  • This trial aims to assess the effectiveness of hyaluronic acid injections, high-power laser therapy, and physiotherapy in improving hip function in patients with osteoarthritis.
  • Randomized controlled trial enrolling 57 adults with hip osteoarthritis (Stages 1–3) and pain rating 4 or higher.
  • Participants received either combined therapy (hyaluronic acid, physiotherapy, active HPLT) or sham HPLT.
  • Primary outcome measured was the Harris Hip Score, with evaluations at baseline and multiple follow-ups.
  • Both groups showed significant improvements in Harris Hip Score (HHS) from baseline to post-treatment (p < 0.001).
  • Study group showed significantly better 6-Minute Walk Test scores compared to control at 3 months (p = 0.029).
  • EuroQoL scores were also significantly higher in the study group at 3 months (p = 0.030).

Abstract

Abstract Purpose High‐power laser therapy (HPLT) is effective in treating musculoskeletal conditions, reducing pain and improving joint functionality. This randomized controlled trial (RCT) aimed to explore the effectiveness of a combination of HPLT, hyaluronic acid injections and rehabilitation for patients with hip osteoarthritis (OA). Methods This RCT enroled adults over 18 with a diagnosis of hip OA (Stages 1–3) who experience hip pain of 4 or higher on a scale. Participants must have a body mass index (BMI) under 30. Patients were randomly assigned to either a study or control group, with both patients and assessors blinded to the treatment. The study group received hyaluronic acid injections, physiotherapy and active HPLT, while the control group received the same management, except for sham HPLT. We used the Harris Hip Score (HHS) as primary outcome to assess hip functioning, and as secondary outcomes the following ones: Numeric Rating Scale (NRS) for pain, EuroQol‐5 Dimension (EQ‐5D) for quality of life and the 6‐Minute Walking Test for physical performance. Evaluations were conducted at multiple time points: baseline (T0), post‐treatment (T1) and follow‐ups at 3 months (T2), 6 months (T3) and 12 months (T4) after the first visit. Moreover, 57 patients were randomly assigned to either a study group ( n = 28) or a control group ( n = 29). Results Both groups showed significant initial improvements in HHS from T0 to T1 ( p < 0.001). However, statistically significant intergroup differences favouring the study group were found for the 6‐Minute Walk Test ( p = 0.029) and the EuroQoL at T3 ( p = 0.030). Conclusion This RCT demonstrated that hyaluronic acid injections and physiotherapy, combined with laser therapy, improve hip function and pain perception in hip OA patients. While laser therapy showed promise, more evidence is needed. Level of Evidence Level I.

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Cite This Study

Sire et al. (2026) studied this question.

synapsesocial.com/papers/6a168b040c924ddd1bd59c5dhttps://doi.org/10.1002/jeo2.70685
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