Exercise Prevents Need for Hip Surgery

Exercise therapy could prevent the need for total hip replacement surgery, according to a new study. In patients with hip osteoarthritis, an educational and exercise program resulted in a 44% decrease in the need for surgery compared to a control group, according to researchers at Oslo University Hospital.

For those who eventually opted for a hip replacement, patients in the exercise program delayed the need for surgery by 5.4 years, compared to 3.5 years in the control group.

"Our finding, that exercise therapy enhances the survival of the native hip to [total hip replacement], is therefore important for healthcare consumption and for patients who may avoid surgery and its potential complications," stated lead author Ida Svege, MD, and his colleagues.

The number of hip replacement operations has increased in the past 40 years, at a significant cost to the healthcare system. Exercise has proven to be successful for adults with knee osteoarthritis. Last year a study suggested physical therapy was effective as surgery for knee OA. However, few studies have examined the effects of exercise therapies for osteoarthritis in the hip.

Svege and his colleagues compared the effects of exercise to education for hip osteoarthritis in 109 adults. Every patient received education hip OA, but half were randomly assigned to an exercise group. Those patients participated in 2-3 exercise sessions per week for four months. Exercise sessions included symptom-targeted therapies.

The exercise group had a significantly better physical functioning than the control group, but were similar in terms of pain and stiffness. Still, the overall survival rate of the native was substantially improved by exercise therapy.

"We argue that for patients with a tolerable pain who are able to maintain their desired activity level and who are relatively young, postponing surgery is appropriate and may reduce the future need for THR [total hip replacement] or repetitive THR revision surgery," the authors wrote.

Chiropractic care is another non-invasive treatment option for patients with hip osteoarthritis. Studies suggest that a combination of exercise therapies and chiropractic adjustments can offer lasting OA relief.

Reference

Sveg I, et al. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomized trial. Annals of Rheumatic Diseases 2013; doi:10.1136/annrheumdis-2013-203628.

Walsh N. Exercise delays need for new hips in OA. Medpage Today. November 22, 2013.