# Effect of platelet-rich plasma combined with simvastatin in the treatment of steroid-induced avascular necrosis of the femoral head

## TL;DR

Combining platelet-rich plasma with simvastatin improves joint function and bone metabolism in patients with steroid-induced femoral head necrosis.

## Contribution

This study demonstrates that PRP combined with simvastatin enhances treatment outcomes for SANFH compared to simvastatin alone.

## Key findings

- PRP combined with simvastatin significantly improved joint function recovery and treatment effectiveness in SANFH patients.
- The combination therapy led to better regulation of bone metabolism markers compared to simvastatin alone.
- No significant difference in adverse reactions was observed between the two treatment groups.

## Abstract

Steroid-induced avascular necrosis of the femoral head (SANFH) is a serious complication of the overuse of glucocorticoids. Platelet-rich plasma (PRP) is a regenerative technique that has shown to effectively repair damaged blood vessels, promote angiogenesis, restore normal blood supply, and promote osteogenesis of the femoral head. This study aimed to analyze the effect of PRP combined with a commonly used simvastatin in treating SANFH.

In this retrospective single-center study clinical data of all SANFH patients who received simvastatin or PRP combined with simvastatin in The Affiliated Hospital of Qingdao University from June 2022 to April 2024 were retrospectively reviewed. Baseline characteristics, recovery of joint function, treatment effect, and incidence of adverse reactions (ARs) were analyzed.

Clinical data of 146 patients who received simvastatin alone (n=75) or PRP combined with simvastatin (n=71) under the guidance of the treating physician were included in the analysis. After the treatment, the recovery of joint function and the rate of excellent and good therapeutic effect in patients who received PRP combined with simvastatin were significantly higher than in patients who received simvastatin treatment alone (P<0.05). Combined treatment was associated with significantly lower levels of total procollagen Type-I N-terminal propeptide (T-PINP), N-terminal molecular fragment (N-MID), and β-isomerized C-terminal telopeptide of Type-I collagen (β-CTX), and higher post-treatment levels of 25 hydroxyvitamin D (25-(OH)-D) compared to simvastatin alone (P<0.05). No significant difference was found in the incidence of ARs between the two groups (P>0.05).

PRP combined with simvastatin can more effectively restore joint function, regulate bone metabolism state, and improve treatment efficiency in patients with SANFH.