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. 2025 May;41(5):1280-1284.
doi: 10.12669/pjms.41.5.11518.

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

Yanchen Chu  1 , Chun Rong  2 , Huili Qu  3 , Haining Zhang  4 , Yuan Fang  5
Affiliations

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

Yanchen Chu et al. Pak J Med Sci. 2025 May.

Abstract

Background & objective: 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.

Methods: 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.

Results: 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).

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

Keywords: Platelet rich plasma; Simvastatin; Steroid-induced avascular necrosis of the femoral head; Therapeutic effect.

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Figures

Fig.1
Fig.1
Histogram of changes in HHS scores of the two groups before and after treatment; Compared with before treatment in the same group. aP<0.05; compared with simvastatin group, bP<0.05; HHS: Harris hip score; PRP: Platelet-rich plasma.
Fig.2
Fig.2
The histogram of bone metabolism index changes in the two groups before and after treatment; Compared with before treatment in the same group. aP<0.05; compared with simvastatin group, bP<0.05; PRP: Platelet rich plasma; T-PINP: total-Type-I collagen N-terminal propeptide; N-MID: N-terminal molecular fragment; β-CTX: β-isomerized C-terminal telopeptide of Type-I collagen; 25-(OH)-D: 25 hydroxyvitamin D.
See this image and copyright information in PMC

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