Osteonecrosis of the hip, also called avascular necrosis, is damage to bone associated with disrupted blood supply. It is not the same diagnosis as ordinary hip osteoarthritis or pain from the tendons on the outside of the hip. Establishing the diagnosis and stage is essential before considering an injection.
Research on PRP for osteonecrosis often concerns its use alongside a surgical procedure such as core decompression. Those results do not establish that a standalone injection into the hip can prevent collapse or replace a hip-preserving operation. The distinction should be explicit in any consultation.
When should hip pain be assessed urgently?
A new inability to bear weight, severe pain after injury, fever with a painful hip or rapidly worsening symptoms needs urgent assessment. Do not wait for an elective injection appointment. Call emergency services for severe illness or an injury that cannot be managed safely.
Persistent deep groin or hip pain also deserves a diagnosis, particularly with relevant risk factors. A normal early X-ray does not necessarily exclude osteonecrosis. Pain location alone cannot distinguish it from arthritis, a stress injury, referred spinal pain or other conditions.
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What does osteonecrosis mean?
The femoral head is the ball at the top of the thighbone. If bone loses an adequate blood supply, it can weaken and eventually collapse. The condition may relate to a previous injury or occur without trauma. Corticosteroid exposure, heavy alcohol use and certain medical conditions are among the factors a clinician may consider.
A risk factor does not prove the diagnosis. Equally, a person should not be reassured only because they do not recognise a risk factor. Give the clinician a full history, including previous hip injury, steroid treatment and relevant blood or systemic disease. Do not stop prescribed steroids abruptly without medical advice.
Which scan answers the question?
Mayo Clinic notes that MRI and CT can reveal early bone changes. The 2026 ARCO evidence-based guideline, endorsed by AAOS, recommends MRI for diagnosing osteonecrosis of the femoral head. It also distinguishes detection of a subchondral fracture from diagnosis alone; CT or MRI may be preferred to plain radiography for that question.
Ask what stage the disease has reached, how much of the femoral head is involved and whether there is a fracture or collapse. These findings influence whether a joint-preserving approach remains an option. Repeating a scan without explaining the treatment decision it informs is not a complete plan.
How does stage change treatment?
Early disease before collapse is a different problem from a femoral head that has already collapsed. Depending on symptoms and findings, treatment may include measures to reduce load, symptom management and a discussion of joint-preserving surgery. Core decompression removes a channel of bone as part of an attempt to preserve the joint; it is not the same as a routine joint injection.
The 2026 ARCO guideline says core decompression can be considered before fracture or collapse, while acknowledging low-quality evidence and uncertainty about the best approach. After collapse, joint replacement may become relevant. Decisions belong with a clinician experienced in hip osteonecrosis and should reflect the imaging, symptoms and patient's priorities.
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What does the PRP evidence actually show?
A systematic review and meta-analysis available through PubMed Central reported favourable pooled outcomes for PRP in osteonecrosis, but the evidence was rated low or very low quality. The included treatment comparisons commonly involved PRP added to core decompression and, in several studies, bone grafting. That context matters more than a headline that says PRP helped hips.
Different preparations, accompanying operations, patient stages and study methods limit how confidently results transfer to an individual. An apparent benefit of an adjunct to surgery cannot establish that an office-based injection alone has the same effect. It also cannot justify a promise to regrow the femoral head or avoid replacement.
Ask which study matches the proposed intervention. Was PRP put into a surgically treated bone lesion, combined with grafting, or injected into the joint? Were patients at the same stage as you? What happened in the comparison group? A clinician should explain these differences in ordinary language before discussing a paid course.
What should you ask before agreeing to treatment?
Request the diagnosis and stage in writing. Ask whether a hip-preservation opinion is needed, what would happen without the proposed treatment and which changes would trigger reassessment. Clarify the goal: reducing pain, preserving bone or improving function are different outcomes and should not be blurred together.
If PRP is proposed, ask whether it is an established part of the plan or an uncertain adjunct, what alternatives exist and who will monitor the hip. A clear plan may recommend no injection. Protecting the right specialist pathway is a valuable result of assessment.
How should London pricing be interpreted?
London Cartilage publicly lists a £1,200 single injection/procedure category including PRP, with stated components. That is another provider's general market example, not our fee and not a price or recommendation for treating osteonecrosis. Surgical procedures, hospital costs, imaging and rehabilitation are separate services.
Ask The London PRP Clinic to confirm the appropriate assessment, location, availability, complete fee and review arrangements. No injection suitability, hip preservation or attendance time is promised by this article. If the diagnosis is osteonecrosis, the first investment should be a well-explained, stage-specific decision rather than an unqualified promise about regeneration.
Discuss an appropriate assessment in London
Sources and evidence limits
- Mayo Clinic: avascular necrosis diagnosis and treatment
- ARCO2026 guideline endorsed by AAOS
- PRP for osteonecrosis: systematic review and meta-analysis
- London Cartilage: published pricing
Sources checked 2 November 2026. Guidance informs assessment, not a diagnosis for an individual. Research results do not guarantee benefit. This article is general information, not personal medical advice. Do not delay urgent care while waiting for an appointment or message reply.