Exercise therapy can delay need for hip replacement

If you have hip osteoarthritis, doing a course of exercise therapy may mean you are less likely to need a hip replacement in the next few years.

INTRODUCTION

Many people get stiff joints from osteoarthritis as they get older. For some people, severe pain and stiffness in their hip joints means they can’t get around very well. Replacing the damaged joint is one option. But hip replacement is a big operation with risks, and artificial hips may wear out eventually. For these reasons, most
people would prefer to delay having a hip replacement until they really need it.

Exercise therapy is another way of treating osteoarthritis. You might worry that exercise could make a damaged joint worse, but we know that exercise can actually help with osteoarthritis. Doctors and physiotherapists can give advice about how to exercise safely.

WHAT DID THE RESEARCHERS HOPE TO FIND?

In this new study the researchers wanted to know whether people with hip osteoarthritis could manage for longer with their natural hip if they took part in a programme of exercise therapy.

WHO WAS STUDIED?

The authors recruited 109 people in Norway, who had mild or moderate hip osteoarthritis that was not bad enough for an immediate hip replacement.

HOW WAS THE STUDY CONDUCTED?

The researchers randomly split the people in the study into two groups. Everyone in both groups went to education sessions about osteoarthritis. But one group was also enrolled in an exercise therapy programme, with two or three sessions a week for 12 weeks. The programme was specifically designed for people with osteoarthritis of the hip, to improve strength and flexibility. The second group of people did not take part in the exercise
programme.

The researchers followed everyone up to see whether they went on to have a hip replacement and, if so, how long after the start of the study they had the operation.

WHAT DOES THE NEW STUDY SAY?

People who had exercise therapy were less likely to have a hip replacement. After six years, 22 of the 55 people who’d had exercise therapy had a hip replacement (which works out at 40 percent, or 40 in 100) compared with 31 of the 54 people not in the exercise group (57 in 100).

People who had exercise therapy were able to wait longer before a hip replacement. The average time before having a hip replacement for people in the exercise group was five and a half years, compared with three and a half years for people who had not had exercise therapy. There was no difference between the groups in how they rated their pain and stiffness. However, people who had exercise therapy did rate their hip function more highly.

HOW RELIABLE ARE THE FINDINGS?

This type of study is called a randomised controlled trial. It’s the best way to show whether a treatment works. The results should be reliable for this group of patients.

WHAT DOES THIS MEAN FOR ME?

If you have mild or moderate symptoms of hip osteoarthritis, this study suggests that an exercise programme may help you avoid or delay hip surgery. You could ask your doctor about taking part in an exercise therapy programme. However, we don’t know if exercise therapy is helpful for delaying hip replacement for people with severe osteoarthritis.

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Date summary prepared: January 2015

Summary based on research article published on: 19 November 2013

From: Svege, I et al. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomised trial. Ann Rheum Dis 2015;74:164-169 doi:10.1136/annrheumdis-2013-203628

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