Randomized controlled trial validates total hip arthroplasty to improve functional capacity

Total hip arthroplasty leads to the best results in the treatment of moderate to severe osteoarthritis of the hip, according to a new study from the University of Eastern Finland and Kuopio University Hospital. During a one-year follow-up, surgery combined with conservative treatment was found to relieve pain and improve functional capacity and quality of life more effectively than conservative treatment alone, which was based on an exercise program.

Total hip replacement is one of the most common surgical procedures. However, the recently published randomized controlled trial comparing the effectiveness of total hip replacement with conservative treatment for moderate to severe hip osteoarthritis is only the second of its kind in the world and the largest to date. A randomized controlled trial is the most reliable study design for investigating treatment effects.

In recent years, the benefits of surgical treatment for musculoskeletal conditions have often been questioned. However, our study now suggests that osteoarthritis of the hip causing pain and functional impairment should be treated surgically if there are no contraindications. In this study, conservative treatment was administered according to standard clinical practice, but its benefits to patients were clearly limited. Patients with moderate to severe osteoarthritis of the hip should therefore be offered surgery without undue delay.”

Heikki Kröger, Professor, University of Eastern Finland

The study included 120 patients with osteoarthritis of the hip, who were randomized to either surgery followed by conservative treatment or conservative treatment alone. Participants in the conservative treatment group were instructed in a self-directed exercise program. The surgical group received the same instructions after undergoing total hip arthroplasty. At baseline and one year later, participants’ physical performance was assessed and various indices were used to assess symptoms, functional capacity and quality of life.

During the one-year follow-up, pain decreased and functional ability improved to a significantly greater extent among those who underwent total hip replacement than among those who received conservative treatment alone. Quality of life and physical performance also improved more in the surgery group.