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


Further research is still required to establish whether being moderately physically active and maintaining muscle strength is the primary prevention of hip OA. Current knowledge suggests that both little loading of the hip joint or hyperphysiological loading may have a detrimental effect on hip articular cartilage, progressing the development of hip OA. Furthermore, exercise has the potential to offer tertiary prevention in mild-moderate and severe hip OA, although there is insufficient evidence to determine whether exercise is a tertiary prevention in patients undergoing THA. The exercise prescribed should consider not only the stage of hip OA but also the general fitness and health of the patient. Only limited evidence exists evaluating the neuromuscular, peri-, and intra-articular mechanisms underlying the beneficial effects of exercise on hip OA, warranting further in vivo studies to delineate the potential secondary prevention provided by exercise in hip OA. We propose shifting the research efforts toward an increased focus on exercise in the preclinical and mild-moderate stage of hip OA, where little is known but the most profound effects of exercise are observed. Furthermore, people with subtle symptoms of early hip OA should be informed about the evidence to provide them with an incentive to implement and maintain regular exercise as medicine through life to prevent or postpone hip OA.