Conservative Treatment for Prearthritic Hip Pathology

A hot debate is often presented on whether or not patients of a particular diagnosis would benefit from conservative treatment or surgical intervention. Of course, there is no universal guideline that determines the appropriate treatment choice for everyone.

Osteoarthritis is a pathology that seems to be affecting people more and more. The most common joints in which this is seen include the knee and hip. With our current understanding of the pathological process of OA and imaging techniques, we are continually improving in our ability to spot patients that are likely to develop arthritis, or in this case identify patients with prearthritic hips.

In this article, a 3-phase study was performed on a sample of patients identified with prearthritic hips. Some were diagnosed with structural abnormalities: hip dysplasia or femoral acetabular impingement; some participants, on the other hand, were diagnosed as having no structural abnormalities.

Interestingly, just under half the sample were satisfied with the outcome of just obtaining conservative treatment, while the rest required surgical intervention. With such a large portion responding favorably to physical therapy, it would appear a trial of PT be attempted before surgery is considered in most individuals with prearthritic hip complaints, especially due to the rigid structure of the conservative care plan. Physical therapists were instructed to follow a protocol's guidelines when treating the patients, while only slightly individualizing the care. Most of the interventions were educational-based, so a more impairment-focused care plan could potentially have even further benefit!

Reference:
Hunt D, Prather H, Harris Hayes M, Clohisy J. "Clinical Outcomes Analysis of Conservative and Surgical Treatment of Patients with Clinical Indications of Prearthritic, Intra-articular Hip Disorders." PM&R: The journal of injury, function and rehabilitation. 4.7 (2012): 479-486. Print.