Hip surgery better than resistance training for adults with severe osteoarthritis (by Patricia Toro, MD MPH)

November 11, 2024

Over 450,000 adults each year have their hip replaced in the US. Osteoarthritis is the most common cause of hip replacements. A typical question is whether non-surgical treatments could replace these surgeries.

The New England Journal of Medicine published research this week comparing hip replacement surgery to resistance training in patients with severe hip osteoarthritis. All 109 patients in this study qualified for hip replacement surgery, and 56 were randomly assigned to resistance training twice weekly for 12 weeks.

The results showed that the outcomes of patient-reported hip pain and function over baseline were better in the group randomized to surgery at six months. One in five (21%) of those assigned to resistance training received a total hip replacement within six months of the trial due to hip pain. Serious adverse events were similar in the two groups.

Implications for employers:

• Physical therapy (PT) continues to be an important treatment modality for patients with musculoskeletal conditions.

• Medical policies that require PT prior to surgery may not be appropriate in every circumstance.

• Employers should be cautious of claims that even intensive physical therapy interventions will decrease long-term rate of hip replacement surgery.

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