New appropriate use criteria for management of hip OA approved by AAOS

The American Academy of Orthopaedic Surgeons Board of Directors approved new appropriate use criteria for management of osteoarthritis of the hip.

Strong recommendations for management of symptomatic OA of the hip include:

- the use of NSAIDs to improve short-term pain, function or both;

- the use of intra-articular corticosteroids to improve function and reduce pain in the short-term; and

- the use of physical therapy as a treatment to improve function and reduce pain.

The AAOS still strongly recommends against the use of intra-articular hyaluronic acid, stating “it does not perform better than placebo for function, stiffness and pain in patients with symptomatic osteoarthritis of the hip.”

Robert H. Quinn, MD, AAOS appropriate use criteria section leader on the committee on evidence-based quality and value, said in a press release that the new criteria provide recommendations on when “hip replacement may be appropriate even when patients have modifiable risk factors, such as obesity, mental health disorders, smoking and diabetes.” He noted surgeons should work with patients on an individual basis and consider the best ways to mitigate these risk factors.

“In these instances, the doctor and patient must weigh the benefits and risks of surgery,” Quinn said in the release. “At the end of the day, it is one surgeon and one patient, and hopefully both are considering the optimal treatment, based on the patient’s particular condition and diagnosis.”

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