Patients with severe hip osteoarthritis who underwent total hip replacement showed an 11.4-point greater improvement in pain and function compared with those in the resistance training group, according to a recent study.
In the multicenter, randomized controlled trial, published in The New England Journal of Medicine, investigators compared the efficacy of total hip replacement (THR) vs resistance training (RT) in patients aged 50 years or older with severe hip osteoarthritis (OA) and surgical indications. The study, involving 109 patients (n = 53 in THR, n = 56 in RT), assessed outcomes in patient-reported hip pain and function using the Oxford Hip Score (OHS).
At 6 months, the patients undergoing THR reported significantly greater improvements on the OHS compared with those in the RT group. The mean increase in OHS was 15.9 points among patients in the THR group vs 4.5 points among those in the RT group, yielding an 11.4-point difference favoring THR (95% confidence interval [CI] = 8.9–14.0, P < .001). Clinically meaningful improvements (≥ 8 points on OHS) were observed in 75% of the patients in the THR group compared with 38% of those in the RT group, a 38 percentage point difference (95% CI = 21–55). At 6 months, 21% of the patients in the RT group had transitioned to THR.
The incidence of serious adverse events was comparable between groups, with 12% in the THR cohort and 9% in the RT cohort experiencing events, primarily known THR complications. At 6 months, THR showed greater improvements in hip-specific quality of life, functional scores, and gait speed; whereas sit-to-stand function improvements were similar between the groups.
These findings indicated that patients with severe hip OA may experience greater improvements in pain relief and function with THR compared with RT. The study results suggested that RT provided some improvement, which may offer an alternative in patients who do not initially opt for surgery. The investigators indicated that THR may provide substantial benefits in this population and could be a factor in shared decision-making discussions.
Full disclosures can be found in the published study.
