THA improved clinical outcomes better than education, exercise in patients with OA
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Key takeaways:
- Total hip arthroplasty for patients with osteoarthritis yielded greater clinical improvements vs. education and exercise.
- Education and exercise could result in THA deferral for some patients.
Despite clinical improvements in patients who received education and exercise for hip osteoarthritis, patients who underwent total hip arthroplasty had greater improvements in pain relief, function and quality of life, according to results.
In a propensity-matched study of 266 patients who presented with hip OA between 2016 and 2019, researchers compared outcomes between patients who underwent THA (n = 133) and patients who completed an education and exercise program without surgery (n = 133). According to the study, the education and exercise program consisted of two education sessions and 12 supervised exercise sessions delivered twice per week for 6 to 8 weeks.
Primary outcome measure was change in Hip Disability and Osteoarthritis Outcome Score 12-item version (HOOS-12) pain score at 1 year. Secondary outcomes included changes in HOOS-12 pain scores at 3 months and changes in HOOS-12 function and quality of life scores at 3 months and 1 year.
Researchers found THA resulted in significantly greater improvements in HOOS-12 pain (mean difference = 35.4), function (mean difference = 30.5) and quality of life (mean difference = 33.6) scores compared with education and exercise at 1 year.
Among patients who received THA, rates of clinically important improvement for pain, function and quality of life at 1 year were 89.5%, 90.2% and 83.5%, respectively. Among patients who received education and exercise, rates of clinically important improvement for pain, function and quality of life at 1 year were 17.3%, 30.1% and 30.1%, respectively.
Researchers concluded there is a substantial clinical benefit that favors THA vs. education and exercise for all outcomes. However, they noted education and exercise may result in THA deferral for some patients who had clinically meaningful improvements.
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