A regenerative approach to an acute exacerbation of hip pain from aromatase inhibitor associated musculoskeletal syndrome and aromatase-inhibitor arthralgias

Background Despite aromatase inhibitors (AIs) promising outcomes in breast cancer treatment, aromatase inhibitor-associated musculoskeletal syndromes (AIMSS) and aromatase inhibitor arthralgias (AIAs) are common side effects, due to the hypoestrogenic state-induced increase in proinflammatory markers. To combat local tissue breakdown elicited by AIs, platelet-rich plasma (PRP) is a proposed interventional treatment due to its modulation of these proinflammatory markers. Materials and Methods A 58-year-old female with a remote history of breast cancer status post radiation and chemotherapy presents with exacerbated left hip pain after letrozole use. After four months of incomplete pain relief, she underwent an ultrasound-guided intraarticular injection of the left hip with PRP. Results Following the PRP injection, the patient experienced improvement of symptoms in the left hip (80% relief, improved visual analog scale (VAS) and Oxford Hip Score), resulting in the continuation of letrozole use for cancer treatment. Conclusions AIMSS is a known side effect of letrozole, limiting an individual's ability to receive cancer treatment. This study reveals a single platelet-rich plasma therapy may be an effective treatment for refractory AIMSS and AIA through modulation of inflammatory markers during a hypoestrogenic state.