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Biologic treatments offer a non-surgical solution for managing hip pain and soft tissue damage. By delivering stem cells, exosomes, or other biologic agents, these therapies aim to reduce inflammation, stimulate tissue repair, and restore joint function.
This protocol outlines a step-by-step clinical approach for applying intra-articular (joint) and intramuscular (IM)biologic injections to treat conditions like osteoarthritis, labral tears, and chronic hip pain.

Best suited for patients who have:
Patients with early to moderate hip osteoarthritis
Individuals with labral tears, tendinopathy, or other soft tissue conditions
Those seeking non-surgical options for managing persistent hip discomfort
Important considerations:
Patients should be free from infection and in stable health
Review medical history to assess suitability for biologic agents
Contraindications:
Active infection near the injection site
Allergies to injectables, anesthetics, or exosome-based products
Severe degeneration that may require surgical intervention
Patients with uncontrolled diabetes, bleeding disorders, or autoimmune conditions may need further assessment or exclusion
Clinic Setup
Use a sterile environment with disinfected surfaces and equipment
Confirm that biologic materials are properly stored and not expired
Essential Equipment:
Biologic solution (stem cell or exosome-based)
3–5 mL sterile syringes
Ultrasound guidance system
Antiseptic skin prep (e.g., alcohol, chlorhexidine)
Local anesthetic (if used)
Patient Prep
Obtain informed consent, outlining procedure, risks, and expected outcomes
Offer local anesthetic and allow proper time for effect
Thoroughly clean the injection site to reduce infection risk
Types of Injection:
Joint Injection (Intra-Articular): Targets inflammation and degeneration within the hip joint
Muscle Injection (Intramuscular): Focuses on injuries to surrounding soft tissues like gluteal muscles
Step-by-Step Protocol:
Use ultrasound to locate and mark injection sites
Draw 1–3 mL of biologic solution into a sterile syringe
For joint injections, slowly administer into the joint space under imaging guidance
For muscle injections, carefully deliver the dose into the injured soft tissue
Apply light pressure post-injection and observe for any immediate reaction
Post-Procedure Instructions:
Limit weight-bearing and high-impact activity for 24–48 hours
Patients may experience mild discomfort or bruising, which typically resolves on its own
Pain Management:
Recommend acetaminophen if needed
Avoid NSAIDs, which may interfere with the healing process
Follow-Up Care:
Schedule a visit 2–4 weeks after treatment
Review mobility, pain levels, and healing progress
Encourage patients to report any concerns such as redness, fever, or severe swelling
Immediate Monitoring:
Observe the patient for 5–10 minutes post-injection for any early reactions
Document and respond to any signs of discomfort or allergy
Emergency Preparedness:
Keep antihistamines and epinephrine on hand in case of allergic reaction
Ensure clinical team is trained in emergency response, though incidents are rare
Preventing Infection:
Use aseptic technique throughout
Avoid reuse of any tools or supplies
Follow up on any post-injection symptoms that suggest infection
First Follow-Up:
Check progress at the 2–4 week follow-up
Document improvements in pain, joint function, and patient feedback
Determine if additional treatments are needed
Long-Term Monitoring:
Recommend periodic check-ins over 6–12 months
If effective, consider repeat injections every 4–6 weeks based on progress and goals
Procedure Records Should Include:
Type, dose, and batch of biologic used
Injection sites and imaging techniques
Patient response during and immediately after the procedure
Any aftercare instructions provided
Tracking Results:
Record follow-up results, including mobility gains and symptom relief
Note any required changes to dosage or protocol frequency over time
Biologic therapy provides a minimally invasive approach to treating hip pain and mobility limitations. Following this structured protocol allows healthcare professionals to offer personalized care while ensuring patient safety and consistency across treatments. When used appropriately, these therapies can delay or reduce the need for surgical procedures and improve quality of life.
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