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Supervised Exercise With Hip Osteoarthritis Allows Patients to Delay Total Hip Replacement

Presented at OARSI Source: DGNews

By Nancy A. Melville

SAN DIEGO — September 20, 2011 — Patients with hip osteoarthritis who take part in a supervised exercise program along with patient education show significantly higher rates of cumulative survival without total hip-replacement surgery compared with those who only receive patient education, according to results of a randomised intervention study presented at the 2011 World Congress of the Osteoarthritis Research Society International (OARSI).

Researchers enrolled 109 subjects with hip osteoarthritis between April 2005 and October 2007. All patients were provided with 3 sessions of patient education, and then were randomised to either a 12-week supervised exercise program (n = 55) or to no further treatment (n = 54). All patients were recommended to follow the information given during the patient education.

Cumulative survival without total hip-replacement surgery was significantly higher for patients going through both a supervised exercise program and patient education compared with patients going through patient education only, despite the fact that there were no significant differences in baseline characteristics between the 2 groups,” according to Ida C. Svege, PT, Oslo University Hospital, Oslo, Norway and colleagues, whose results were presented here on September 17.

The patients were aged 40 to 80 years and had Harris Hip Scores between 60 and 95 points — meaning their impairments were not severe enough for consideration for total hip replacement at the time of inclusion.

Patients assigned to the supervised-exercise group received strength training, functional exercises, and flexibility exercises with a physical therapist 2 to 3 times per week.

The 2 groups had no significant differences at baseline in any characteristics or assessments, including age, gender, minimal joint space, Harris Hip Score, and self-reported pain and function.

In follow-up telephone calls 3.5 to 6 years later, the researchers found that a total of 53 patients (48.6%) had gone through total hip replacement between their time of enrolment and the follow-up call.

Among them, 22 patients (40.0%) were in the group that received the supervised exercise in addition to the education, compared with 31 patients (57.4%) in the patient education-only group.

The median time to total hip-replacement surgery in the supervised-exercise group was 1,953 days (95% confidence interval [CI], 1,634-2,272 days), compared with 1,260 days for the patient education-only group (95% CI, 850-1,670 days).

The cumulative survival without total hip-replacement surgery after 6 years was 41.4% in the supervised-exercise group and 25.4% in the patient education-only group (P =.034).

“The findings of this study suggest that supervised exercises in addition to patient education may postpone the need for total hip-replacement surgery in patients with hip osteoarthritis,” the authors concluded.

[Presentation title: Time to Total Hip Replacement Surgery After Supervised Exercise and Patient Education in Patients With Hip Osteoarthritis. A Randomized Intervention Study With Between 3.5 and 6 Years Follow-Up. Abstract 86]