THA vs. Resistance Training for Hip OA
A study by Frydental et al. (2024) compared the effectiveness of Total Hip Arthroplasty (THA) to resistance training in individuals with severe hip osteoarthritis. After six months, the surgical group reported significantly better pain relief and functional outcomes. The takeaway? If you need a THA, it can be a game-changer for your quality of life.
As a physiotherapist, I fully support THA when conservative interventions have plateaued or when a patient’s condition continues to worsen despite physiotherapy.
Mental Health and THA Outcomes
While THA boasts a 93% satisfaction rate, it’s important to recognize that 7% of patients remain dissatisfied postoperatively for various reasons. Harmer et al. (2023) identified a strong association between preoperative mental health conditions (depression, anxiety, or catastrophization) and poorer surgical outcomes, including a higher risk of infection, reoperation, and dissatisfaction.
Recommendation: Patients with significant mental health concerns should be encouraged to address these issues prior to surgery. A better mental health status may lead to improved outcomes post-THA.
The Role of Physiotherapy After THA
A review by Fatoye et al. (2020) confirmed that physiotherapy interventions are clinically effective for individuals recovering from THA. However, the question remains: what is the most effective physiotherapy approach?
Dudidiene et al. (2023) conducted a randomized controlled trial comparing conventional physiotherapy exercises (CPE) with task-oriented exercises (TOE) in post-THA patients.
Conventional Physiotherapy (CPE): Included traditional exercises like supine bridging, hip abduction, Swiss ball exercises, and cycling.
Task-Oriented Exercises (TOE): Focused on functional movements, including:
- Walking (forward, backward, sideways) with high knee lifts
- Catching and throwing balls
- Sit-to-stand exercises with reaching
- Stair climbing with reaching
- Walking with directional changes
- Climbing over obstacles
Key Findings: Both groups experienced similar improvements in pain and functional outcomes. However, the TOE group showed significantly greater improvements in dynamic balance, which could potentially reduce the risk of future falls.
Conclusion
THA has the potential to transform lives, particularly when complemented by effective physiotherapy interventions. Based on current evidence, task-oriented exercises may offer additional benefits by enhancing dynamic balance and reducing fall risk. For patients considering THA, addressing mental health, pursuing post-op physiotherapy, and selecting task-oriented approaches may maximize surgical outcomes.
I personally love prescribing STARmat exercises and while at the clinic I play catch with them while they step in various directions.
You may view sample STARmat exercises HERE. If interested, you may order the STARmat HERE.