Randomized controlled trial validates total hip arthroplasty for improving functional capacity

Total hip arthroplasty leads to the best outcomes in the treatment of moderate-to-severe hip osteoarthritis, according to a new study by 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 arthroplasty is one of the most common surgical procedures. However, the newly published randomized controlled trial comparing the effectiveness of total hip arthroplasty with conservative treatment for moderate-to-severe hip osteoarthritis is only the second of its kind in the world and the longest to date. A randomized controlled trial is the most reliable study design for investigating treatment outcomes.

In recent years, the benefits of surgical treatment for musculoskeletal disorders have often been questioned. However, our study now suggests that hip osteoarthritis causing pain and functional impairment should be treated surgically if there are no contraindications. In this study, conservative treatment was provided in line with established clinical practice, yet its benefits for patients were clearly limited. Patients with moderate-to-severe hip osteoarthritis should therefore be offered surgery without unnecessary delay."

Heikki Kröger, Professor, University of Eastern Finland

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

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