Over 200,000 Americans undergo a total hip replacement often as a treatment for severe hip osteoarthritis. Patients who enter the surgery in a weakened, less functional state have worse outcomes up to 2 years post operatively compared to their higher functioning peers (Fortin et al. 1999, 2002). This is concerning because the most rapid recovery after surgery occurs in the first 3 months with slower recovery up to 1 year. A patient with more difficulty entering surgery would have limited success in this crucial window in their recovery. Conversely, pre operative Physical Therapy for patients with limited flexibility, strength, balance, and endurance can improve surgical outcomes. Similar to research in knee osteoarthritis, a manual therapy and exercise approach can delay or prevent the need for the surgery.
A recent study was conducted to determine the long term impact of PT interventions on patients with hip osteoarthritis (Svege et al. Ann Rheum Dis. 2015). Patients were randomized to either an education or PT group and followed up to 6 years after the treatment. The authors reported the average time to a total hip replacement was 5.5 years in the Physical Therapy group compared to 3.5 years in the education group demonstrating these interventions may delay the need for a hip replacement. In addition, twice as many patients in the Physical Therapy group did not require surgery reducing the need for surgery by 44%.
This evidence adds to our knowledge on the beneficial effects of Physical Therapy on patients with hip osteoarthritis. Patients with hip pain are advised to see a Physical Therapist to postpone or prevent the need for a total hip replacement.
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