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Hip osteoarthritis
Guidelines
Key sources
The following summarized guidelines for the management of hip osteoarthritis are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2024,2020), the American Academy of Orthopaedic Surgeons (AAOS 2024), the American Psychological Association (APA 2024), the European Committee on Infection Control (EUCIC/ESCMID 2024), the European League Against Rheumatism (EULAR 2024), the American College ...
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Medical management
Non-opioid analgesics
As per AAOS 2024 guidelines:
Offer oral NSAIDs to reduce pain and improve function in patients with symptomatic hip OA, unless contraindicated.
A
Consider offering oral acetaminophen to improve pain and function in patients with symptomatic hip OA, unless contraindicated.
E
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Opioids
Duloxetine
Agents with no evidence for benefit
Nonpharmacologic interventions
General principles
As per EULAR 2024 guidelines:
Offer an individualized, multicomponent management plan including the recommended core nonpharmacological approaches in patients with hip OA.
A
Consider employing elements of behavior change techniques when lifestyle modifications are needed, such as physical activity and weight loss, in patients with hip OA.
B
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Weight loss
Physical therapy
Self-management programs
Walking aids and footwear
CBT
Occupational therapy
Alternative and complementary therapies
Therapeutic procedures
Intra-articular corticosteroids: as per AAFP 2024 guidelines, consider administering intra-articular corticosteroid injections for the management of pain in patients with hip OA.
C
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Other intra-articular injections
Transcutaneous electrical nerve stimulation
Perioperative care
Anesthesia: as per AAOS 2024 guidelines, consider administering neuraxial anesthesia to reduce adverse events in patients undergoing total hip arthroplasty.
C
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Preoperative decolonization and antibiotic prophylaxis
Perioperative tranexamic acid
Postoperative physical therapy
Surgical interventions
Total hip arthroplasty, timing: as per AAHKS/ACR 2023 guidelines, consider performing elective hip arthroplasty without delay, rather than delaying for 3 months,
C
or for a trial of physical therapy, C
NSAIDs, intra-articular corticosteroid injections, viscosupplementation injections, or braces and/or ambulatory aids, in patients with radiographically moderate-to-severe OA with moderate-to-severe pain or loss of function eligible for elective total joint arthroplasty decided through a shared decision-making process and completed ≥ 1 trial of appropriate nonoperative therapy. C
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Total hip arthroplasty (prognostic factors)
Total hip arthroplasty (technical considerations)