Last updated January 14, 2022

Management of Osteoarthritis of the Hip

Recommendation

RISK ASSESSMENT TOOLS

Moderate strength evidence supports that the practitioner could use risk assessment tools to assist in predicting adverse events, assessing surgical risks and educating patients with symptomatic osteoarthritis of the hip undergoing total hip arthroplasty. (M)
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OBESITY AS A RISK FACTOR

Moderate strength evidence supports that obese patients with symptomatic osteoarthritis ofthe hip, when compared to non-obese patients, may achieve lower absolute outcome scores but a similar level of patient satisfaction and relative improvement in pain and function after total hip arthroplasty. (M)
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Limited strength evidence supports that obese patients with symptomatic osteoarthritis ofthe hip, when compared to non-obese patients, have increased incidence of postoperative dislocation, superficial wound infection, and blood loss after total hip arthroplasty. (L)
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AGE AS A RISK FACTOR

Moderate strength evidence supports that increased age is associated with lower functional and quality of life outcomes in patients with symptomatic osteoarthritis of the hip undergoing total hip arthroplasty. (M)
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Limited strength evidence supports that increased age may be associated with a higher riskof mortality in patients with symptomatic osteoarthritis of the hip undergoing total hip arthroplasty. (L)
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Limited strength evidence supports that younger age may be associated with a higher riskof revision in patients with symptomatic osteoarthritis of the hip undergoing total hip arthroplasty. (L)
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MENTAL HEALTH DISORDER AS A RISK FACTOR

Moderate strength evidence supports that mental health disorders, such as depression, anxiety, and psychosis, are associated with decreased function, pain relief, and quality of life outcomes in patients with symptomatic osteoarthritis of the hip who undergo total hip arthroplasty (THA). (M)
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TOBACCO USE

Limited strength evidence supports that patients who use tobacco products are at an increased risk for complications after total hip arthroplasty. (L)
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NON-NARCOTIC MANAGEMENT

Strong evidence supports that NSAIDs improve short-term pain, function, or both in patients with symptomatic osteoarthritis of the hip. (S)
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GLUCOSAMINE SULFATE

Moderate strength evidence does not support the use of glucosamine sulfate because it did not perform better than placebo for improving function, reducing stiffness and decreasing pain for patients with symptomatic osteoarthritis of the hip. (M)
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INTRAARTICULAR INJECTABLES

Strong evidence supports the use of intraarticular corticosteroids to improve function and reduce pain in the short-term for patients with symptomatic osteoarthritis of the hip. (S)
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Strong evidence does not support the use of intraarticular hyaluronic acid because it does not perform better than placebo for function, stiffness, and pain in patients with symptomatic osteoarthritis of the hip. (S)
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PHYSICAL THERAPY AS A CONSERVATIVE TREATMENT

Strong evidence supports the use of physical therapy as a treatment to improve function and reduce pain for patients with osteoarthritis of the hip and mild to moderate symptoms. (S)
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PREOPERATIVE PHYSICAL THERAPY

Limited evidence supports the use of pre-operative physical therapy to improve early function in patients with symptomatic osteoarthritis of the hip following total hip arthroplasty. (L)
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ANESTHETIC TYPES

Limited evidence supports the use of neuraxial anesthesia compared to general anesthesia to reduce complications in patients with symptomatic osteoarthritis of the hip undergoing total hip arthroplasty. (L)
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Recommendation Grading

Overview

Title

Management of Osteoarthritis of the Hip

Authoring Organization

Endorsing Organizations

Publication Month/Year

March 13, 2017

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Adult, Older adult

Health Care Settings

Ambulatory, Emergency care, Home health, Hospital, Long term care, Operating and recovery room, Outpatient

Intended Users

Physical therapist, occupational therapist

Scope

Assessment and screening, Diagnosis, Rehabilitation, Management, Treatment

Diseases/Conditions (MeSH)

D015207 - Osteoarthritis, Hip

Keywords

hip osteoarthritis, total hip arthroplasty (THR)