Initial Physical Therapy vs. Surgery in Patients with Severe Hip Osteoarthritis

Although prescribing a trial of physical therapy before referral for total hip arthroplasty (THA) is common practice, we don't have comparisons of outcomes after initial resistance training versus advancing to THA immediately after consultation with an orthopedist. In this Danish trial, 109 patients with severe hip osteoarthritis (OA) were randomized to either immediate THA or twice-weekly supervised resistance training for 12 weeks. Patients were assessed at 6, 12, and 24 months with a validated patient-reported outcome scale (Oxford Hip Score: range, 0–48 points, with higher scores reflecting better outcomes; mean baseline score, 25).

At 6 months, patients who underwent THA had significantly greater improvement than did those in the resist…