What are the OARSI recommendations for the treatment of hip OA?

Updated: Jun 10, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In the 2019 Osteoarthritis Research Society International (OARSI) guidelines, the only hip osteoarthritis (OA) interventions considered eligible for Core Treatment designation (treatments deemed appropriate for use by the majority of patients in nearly any scenario and deemed safe for use in conjunction with first-line and second-line treatments) were arthritis education and structured land-based exercise programs (Type 1 –  strengthening and/or cardio and/or balance training/neuromuscular). [153]

Conditional OARSI recommendations for hip arthritis include the following:

  • Mind-body exercise (tai chi or yoga), despite despite a lack of direct evidence, because its favorable efficacy and safety profile in patients with knee OA was considered generalizable to hip OA.
  • Self-management programs
  • Cognitive behavioral therapy for patients with widespread pain and/or depression.
  • The use of gait aids, except in patients with widespread pain and/or depression
  • Use of oral nonsteroidal anti-inflammatory drugs (NSAIDs) for hip OA patients without comorbidities and for patients with widespread pain and/or depression.
  • For patients with GI comorbidities, oral NSAID therapy should be restricted to selective COX-2 inhibitors or non-selective NSAIDs in combination with a proton pump inhibitor.
  • NSAIDs with more favorable safety profiles may be used in high-risk patients (including patients with frailty) at the lowest possible dose, for the shortest possible treatment duration, for symptomatic relief.

Dietary weight management was not recommended for patients with hip OA because of lack of direct evidence for its effectiveness specifically for symptoms of Hip OA. However, dietary weight management may be recommended for certain individuals (eg, those with body mass index ≥30 kg/m2) as a part of a healthy lifestyle regimen. [153]


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