Exercise as Medicine During the Course of Hip Osteoarthritis

Inger Mechlenburg; Lisa Cecilie Urup Reimer; Troels Kjeldsen; Thomas Frydendal; Ulrik Dalgas


Exerc Sport Sci Rev. 2021;49(2):77-87. 

In This Article

Future Directions for Research

At the preclinical phase of hip OA, the relations between PA, injuries, and occupation and the risk of developing hip OA are inconsistent, and future studies may wish to consider addressing this need in high-quality studies with long-term follow-up.

The evidence of exercise for patients with mild-moderate hip OA is of moderate quality and shows promising effects. Importantly, no more RCTs comparing exercise to a control group in improving pain and patient-reported or performance-based function are needed. However, high-quality studies comparing the effects of different exercise modalities on pain, patient-reported and performance-based function, and QoL are warranted. In addition, studies investigating how to sustain the effects of the initial exercise interventions in the long run are highly warranted.

Exercise may offer tertiary prevention in terms of relieving pain and improving patient-reported and performance-based function and muscle strength in patients with severe hip OA when assessed before or shortly after THA, whereas the effects seem to cease at longer follow-up. Currently, only pilot data exist on whether exercise may be a viable treatment option for postponing or even replacing THA in some patients with severe hip OA. Of note, this knowledge gap is currently being investigated in two ongoing RCTs, which may have important implications for the treatment of severe hip OA.[93,94]

Finally, high-quality, adequately powered studies investigating the effects of exercise after THA in the early and late recovery phase are warranted. Furthermore, RCTs with long-term follow-up and with detailed descriptions of exercise interventions are needed as a knowledge gap exists regarding the dose-response relation. Equally important, focus should be directed toward investigating which exercise modality is most effective in improving pain, patient-reported and performance-based function, and QoL.