None listed
Conditions
Brief summary
Hip osteoarthritis (OA) is associated with significant personal and societal burden, which is rising with increased life expectancy. Early hip OA is commonly seen during hip arthroscopic surgery, and can affect younger adults (age<55 years) with peak work and family commitments. Whilst hip arthroscopy is commonly undertaken for pain associated with early hip OA, no studies have examined best practice for post-operative rehabilitation. An effective intervention for early-onset hip OA will potentially have great personal and societal impact. The primary aim of this study is to establish the feasibility of a randomised clinical trial (RCT) of physiotherapy, targeted to improve hip joint range and hip-related symptoms in early-onset hip OA. This study is a blinded pilot RCT conforming to CONSORT guidelines. Twenty people with early hip OA who had hip arthroscopy surgery six to 12 months previously will be recruited and randomized to the intervention group (individualized manual therapy, exercise therapy and education) or the control group (education only). Eight interventions will occur for both groups over three months, with outcomes collected at baseline and three months. Primary outcome measure - feasibility of a full scale RCT. Secondary outcome measures - symptoms, quality-of-life and range-of-motion.
Interventions
Interventions
Each participant will be treated by experienced physiotherapists who will be trained and proficient in both interventions (physiotherapy; education).
Physiotherapy
The physiotherapy intervention will be delivered in 8 sessions each of 30 minutes duration over 3-months (1/week for 4 weeks, 1/fortnight for 8 weeks). This consists of (i) manual hip joint and soft tissue mobilisation and stretching; (ii) hip muscle retraining; (iii) trunk muscle retraining; (iv) functional, proprioce
Interventions Each participant will be treated by experienced physiotherapists who will be trained and proficient in both interventions (physiotherapy; education). Physiotherapy The physiotherapy intervention will be delivered in 8 sessions each of 30 minutes duration over 3-months (1/week for 4 weeks, 1/fortnight for 8 weeks). This consists of (i) manual hip joint and soft tissue mobilisation and stretching; (ii) hip muscle retraining; (iii) trunk muscle retraining; (iv) functional, proprioceptive and sports- or activity- specific retraining; (v) enhancing physical activity; and (vi) education. Education will consist of topics including exercise, weight loss if appropriate, and appropriate stretching. This will be provided during thwe physiotherapy session. Based on our pilot data, the treatment will be tailored according to each patient’s clinical presentation (e.g. strength, pain severity, sporting and functional needs), presence of co-morbidities (e.g. back and other lower-limb pain or pathology) and progressed based on response to exercise load, thus maximising the training effects. The physiotherapist will supervise exercises during each visit for 15 minutes. A home exercise program will be performed independently at home 4 times per week for 60 minutes per session. An exercise manual will be produced and made accessible to each participant. Participants will complete a self report diary which will be checked at each visit and include adherence to home exercise program, use of medications and additional activity undertaken.
Sponsors
The University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
Inclusion Criteria: (i) aged 18-50 yr; (ii) arthroscopy for intra-articular hip pathology during the past 12 to 36 months; (iii) evidence of early-onset hip OA (defined as chondropathy greater than or equal to Outerbridge grade 1) at time of hip arthroscopy; (iv) hip-related pain > 30 on a 100mm Visual Analogue Scale (VAS).
Exclusion criteria
Exclusion Criteria: (i) pain that is not confirmed by physical examination of the hip; (ii) concurrent symptoms of hip bursitis or tendinitis; (iii) surgical complications including infection; (iv) planned lower limb surgery in the following 12 months (eg arthroplasty); (v) physical inability to weight-bear fully or undertake testing procedures; (vi) inability to understand written and spoken English.
Outcome results
None listed