AAOS releases new clinical practice guideline for osteoarthritis of the hip

April 11, 2017, American Academy of Orthopaedic Surgeons

The American Academy of Orthopaedic Surgeons (AAOS) recently released a new clinical practice guideline (CPG) on the treatment of osteoarthritis of the hip that strongly recommends the use of pre-surgical treatments to ease pain and improve mobility, including corticosteroid injections, physical therapy and non-narcotic medications. The new guidelines do not recommend the use of hyaluronic acid or glucosamine sulfate to minimize osteoarthritis symptoms, due to a lack of evidence supporting the efficacy of these treatments. In addition, there are no clinically significant differences in patient-oriented outcomes related to hip surgery approach—either anterior or posterior used during following total hip replacement (THR) surgery.

"The strongest CPG recommendations supported the use of intraarticular corticosteroids, physical therapy, and non-narcotic pharmacologic management as conservative treatments for patients with prior to surgery," said Gregory Polkowski, MD, chair of the CPG Work Group on the Treatment of Osteoarthritis of the Hip.

The CPG also states that patients with moderate obesity (a body mass index greater than 30) and severe osteoarthritis of the hip may achieve lower outcome scores following THR when compared to non-obese patients; however, these patients have a similar level of satisfaction and relative improvement in pain and function after THR. In addition, there is limited existing evidence to support that patients who use tobacco products are at an increased risk for complications after THR. Age was moderately associated with lower function and quality of life outcomes; and mental health disorders (depression, anxiety and psychosis) with decreased function, pain relief and quality of life following surgery.

"These patients are still reasonable candidates for a that we know is very effective. The use of risk assessment tools may help inform these patients, and their surgeons, about the potential for increased risk," said Robert H. Quinn, MD, AAOS Appropriate Use Criteria (AUC) Section Leader on the Committee on Evidence-Based Quality and Value.

"These topics were included in this CPG to establish current levels of evidence, and to highlight that future research needs to be conducted in these areas to better determine specifically how preoperative risk modification may affect the outcome of total hip arthroplasty surgery," said Dr. Polkowski.

With strong or moderate evidence, the CPG does recommend:

  • The use of risk assessment tools to assist in predicting patient complications, assessing surgical risks and educating osteoarthritis patients who are undergoing THR.
  • The use of corticosteroid injections to improve function and reduce pain "in the short-term" for patients with osteoarthritis of the hip.
  • Physical therapy as a conservative treatment to reduce pain in patients with mild to moderate osteoarthritis of the hip.
  • The use of non-narcotic medications and, specifically, non-steroidal anti-inflammatory drugs (NSAIDs) to improve short-term pain, function or both in patients with symptomatic of the hip.
  • Postoperative after THR to improve early function.
  • The use of tranexamic acid, injected or administered at the surgical site, for undergoing THR to minimize blood loss.

Explore further: One-third of costs prior to knee replacement for non-recommended therapies

Related Stories

One-third of costs prior to knee replacement for non-recommended therapies

March 14, 2017
In the year prior to total knee replacement (TKR) surgery, almost one-third of the costs for treatment of arthritis symptoms went toward strategies not recommended by the American Academy of Orthopaedic Surgeons (AAOS), according ...

Age not a factor in success of shoulder replacement surgery

March 15, 2017
Whether you're younger than 65 or older than 75, age may not be a discernible factor in the success of shoulder replacement surgery, according to a Henry Ford Hospital study.

Knee surgery may have minimal quality of life effects in those with less severe symptoms

March 28, 2017
Knee replacement surgery for patients with osteoarthritis, as currently used, provides minimal improvements in quality of life and is economically unattractive, according to a study led by Mount Sinai researchers and published ...

AAOS Board approves treatment criteria for carpal tunnel syndrome and knee osteoarthritis

December 12, 2016
The American Academy of Orthopaedic Surgeons (AAOS) Board of Directors has approved new Appropriate Use Criteria (AUC) for the management of carpal tunnel syndrome (CTS) and the surgical management of osteoarthritis of the ...

Tai Chi improves pain and well-being in patients with knee osteoarthritis

May 16, 2016
Tai Chi improves pain and related health outcomes in patients with knee osteoarthritis as well as standard physical therapy, according to a comparative effectiveness trial published in Annals of Internal Medicine. Tai Chi ...

AAOS releases guidelines for surgical treatment of osteoarthritis of the knee

December 10, 2015
The American Academy of Orthopaedic Surgeons (AAOS) today introduced a new clinical practice guideline (CPG) for adults undergoing surgery to improve motion and relieve pain caused by osteoarthritis of the knee. The guidelines ...

Recommended for you

First major study comparing robotic to open surgery published in The Lancet

June 21, 2018
The first comprehensive study comparing the outcomes of robotic surgery to those of traditional open surgery in any organ has found that the surgeries are equally effective in treating bladder cancer. The seven-year study, ...

Antibodies may predict transplant rejection risk

June 19, 2018
The presence of certain antibodies in patients may suggest a higher risk of transplant rejection across multiple organ types, including the kidney, liver, heart and lungs, according to a new study published in PLOS Medicine.

First human test of robotic eye surgery a success

June 18, 2018
Researchers from the University of Oxford have completed the first successful trial of robot-assisted retinal surgery.

Surgical blood transfusions tied to clot risk

June 13, 2018
(HealthDay)—Blood transfusions around the time of surgery may raise your risk for dangerous blood clots, researchers say.

Tonsil and adenoid removal associated with respiratory, allergic and infectious disease

June 7, 2018
Tonsil and adenoid removal associated with long-term risks of respiratory, allergic and infectious diseases Removing tonsils and adenoids in childhood increases the long-term risk of respiratory, allergic and infectious diseases, ...

Clues found to early lung transplant failure

May 21, 2018
Among organ transplant patients, those receiving new lungs face a higher rate of organ failure and death compared with people undergoing heart, kidney and liver transplants. One of the culprits is inflammation that damages ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.