What can you try before hip surgery?

Which hip replacement alternatives come first?

Name the daily task that has become hard. You may want easier stairs or longer walks. You'll use that task to judge whether care helps.

Gentle movement often comes first. Shorter walks can calm a strong flare. Hip and thigh exercises may build useful strength.

A cane can take some body weight off your sore leg while you walk. Ask a clinician to check the fit. Medicines won't suit everyone, so have your doctor or pharmacist review them.

Which choices does QC Kinetix discuss?

QC Kinetix medical providers start with a hip exam at the Chandler clinic. They may discuss regenerative treatments such as PRP, made from the platelet-rich part of your own blood. PRP stands for platelet-rich plasma.

A provider spins some of your blood, keeps the platelet-rich part, and places it into the sore area. Concentrated PRP is prepared to keep more platelets in that part. Ask why either choice may fit your hip.

Hip research doesn't give one answer about PRP. Knee results can't settle how well it works for hips. Ask when the clinic will check whether walking, sleep, or chair rises feel easier.

When does surgery make sense?

Soreness at rest can change your decision. So can lost sleep or very limited walking. Surgery may fit when joint wear is severe and other care hasn't helped enough.

Ask why replacement is advised now. Ask what waiting could change for your hip. Hip replacement alternatives shouldn't delay an operation you need.

Sources

1. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programmes, tai chi, cane use and oral NSAIDs across hand, hip and knee OA - but its strong recommendations for topical NSAIDs and for intra-articular glucocorticoid injection are specific to the KNEE, not the hip.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis & Rheumatology, 2020. DOI: 10.1002/art.41142.

2. OARSI 2019 designates arthritis education plus structured land-based exercise as CORE treatments for hip OA, and explicitly states that intra-articular corticosteroids, intra-articular hyaluronic acid and aquatic exercise - Level 1B/2 treatments for KNEE OA - were NOT recommended for individuals with hip or polyarticular OA. Oral and transdermal opioids are strongly not recommended (Level 5).

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis and Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

3. The AAOS evidence-based clinical practice guideline on Management of Osteoarthritis of the Hip states verbatim: STRONG evidence supports intra-articular corticosteroids to improve function and reduce pain in the SHORT TERM; STRONG evidence does NOT support intra-articular hyaluronic acid, because it does not perform better than placebo for function, stiffness and pain; STRONG evidence supports physical therapy for mild to moderate symptoms; STRONG evidence supports NSAIDs for short-term pain and function; and MODERATE evidence does not support glucosamine sulfate.

   American Academy of Orthopaedic Surgeons — Management of Osteoarthritis of the Hip: Evidence-Based Clinical Practice Guideline.. AAOS, 2017.

4. The AAOS 2024 clinical practice guideline summary for management of osteoarthritis of the hip is based on a systematic review of studies in adults 18 and older and contains eight recommendations and nine options; it also explicitly highlights gaps in the literature and areas needing future research.

   Hannon CP, et al. — American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary: Management of Osteoarthritis of the Hip.. Journal of the American Academy of Orthopaedic Surgeons, 2024. DOI: 10.5435/JAAOS-D-24-00420.

5. NICE guideline NG226 (2022) covers the diagnosis, assessment and non-surgical management of osteoarthritis in people over 16 across the UK NHS, replacing CG177. It is the reference point for the therapeutic-exercise-first model used in most guideline-concordant OA care.

   National Institute for Health and Care Excellence — Osteoarthritis in over 16s: diagnosis and management (NG226).. NICE, 2022.

6. A 106-patient double-blind RCT found a single INTRAMUSCULAR gluteal injection of 40 mg triamcinolone reduced hip pain at rest more than placebo at 2 weeks (difference -1.3, 95% CI -2.3 to -0.3) with effects on walking pain and WOMAC pain persisting to 12 weeks - relevant because intramuscular injection avoids entering the joint.

   Dorleijn DMJ, et al. — Intramuscular glucocorticoid injection versus placebo injection in hip osteoarthritis: a 12-week blinded randomised controlled trial.. Annals of the Rheumatic Diseases, 2018. DOI: 10.1136/annrheumdis-2017-212628.