2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T7f2,The aim of this study was to compare clinical, performance-based, and patient-reported outcomes between patients with moderate-to-severe hip osteoarthritis (OA) who were treated with total hip arthroplasty (THA) or conservative treatment with a self-directed exercise programme. We conducted a single-centre, randomized controlled trial including 120 participants with radiologically confirmed moderate-to-severe hip OA (Kellgren-Lawrence grades 2 to 4). Participants were randomly allocated (1:1) to receive either THA combined with postoperative rehabilitation or a self-directed exercise programme. The primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Harris Hip Score (HHS) at 12 months. Minimal clinically important differences (MCIDs) were predefined as 11 points for WOMAC and 15.9 points for HHS. Secondary outcomes included WOMAC at six months, as well as WOMAC subscales, health-related quality of life (HRQoL) RAND 36-Item Health Survey 1.0 (RAND-36) domains, and physical performance tests (chair stand, 40 m walk, and stair climb). At 12 months, the THA group demonstrated significantly greater improvements than the conservative group in WOMAC total score (-30.9 (95% CI -34.9 to -27.0) vs -3.7 (95% CI -8.2 to 0.9; between-group difference -27.1 points (95% CI -32.4 to -21.8)) and HHS (29.8 (95% CI 25.8 to 33.9) vs 5.7 (95% CI 2.4 to 9.0); difference 24.1 (95% CI 19.6 to 28.7)), both exceeding MCID thresholds. Overall, 23 participants (38%) in the conservative group underwent THA during the study; two participants in the THA group declined surgery. The THA group also showed superior gains across all performance-based tests and most RAND-36 domains. In patients with moderate-to-severe hip OA, THA combined with postoperative rehabilitation provides clinically meaningful improvements in pain, function, and HRQoL compared with a self-directed exercise programme alone. These findings reinforce THA as the preferred option for eligible patients.31:Tb07, Aims The aim of this study was to compare clinical, performance-based, and patient-reported outcomes between patients with moderate-to-severe hip osteoarthritis (OA) who were treated with total hip arthroplasty (THA) or conservative treatment with a self-directed exercise programme. Methods We conducted a single-centre, randomized controlled trial including 120 participants with radiologically confirmed moderate-to-severe hip OA (Kellgren-Lawrence grades 2 to 4). Participants were randomly allocated (1:1) to receive either THA combined with postoperative rehabilitation or a self-directed exercise programme. The primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Harris Hip Score (HHS) at 12 months. Minimal clinically important differences (MCIDs) were predefined as 11 points for WOMAC and 15.9 points for HHS. Secondary outcomes included WOMAC at six months, as well as WOMAC subscales, health-related quality of life (HRQoL) RAND 36-Item Health Survey 1.0 (RAND-36) domains, and physical performance tests (chair stand, 40 m walk, and stair climb). Results At 12 months, the THA group demonstrated significantly greater improvements than the conservative group in WOMAC total score (-30.9 (95% CI -34.9 to -27.0) vs -3.7 (95% CI -8.2 to 0.9; between-group difference -27.1 points (95% CI -32.4 to -21.8)) and HHS (29.8 (95% CI 25.8 to 33.9) vs 5.7 (95% CI 2.4 to 9.0); difference 24.1 (95% CI 19.6 to 28.7)), both exceeding MCID thresholds. Overall, 23 participants (38%) in the conservative group underwent THA during the study; two participants in the THA group declined surgery. The THA group also showed superior gains across all performance-based tests and most RAND-36 domains. Conclusion In patients with moderate-to-severe hip OA, THA combined with postoperative rehabilitation provides clinically meaningful improvements in pain, function, and HRQoL compared with a self-directed exercise programme alone. These findings reinforce THA as the preferred option for eligible patients. Cite this article: Bone Joint J 2026;108-B(5):588–596. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Joint Arthroplasty: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Joint Arthroplasty (modality). Clinician-written summaries and actionable practice insights. 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Overall, 23 participants (38%) in the conservative group underwent THA during the study; two participants in the THA group declined surgery. The THA group also showed superior gains across all performance-based tests and most RAND-36 domains.","abstract":"$30","keywords":[],"pubmed_id":"42061873","conclusions":"In patients with moderate-to-severe hip OA, THA combined with postoperative rehabilitation provides clinically meaningful improvements in pain, function, and HRQoL compared with a self-directed exercise programme alone. These findings reinforce THA as the preferred option for eligible patients.","publication_date":"2026-05-01T00:00:00"},"crossref":{"DOI":"10.1302/0301-620x.108b5.bjj-2025-0858.r2","URL":"https://doi.org/10.1302/0301-620x.108b5.bjj-2025-0858.r2","ISSN":["2049-4408","2049-4394"],"link":[{"URL":"https://boneandjoint.org.uk/doi/10.1302/0301-620X.108B5.BJJ-2025-0858.R2/xml","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://boneandjoint.org.uk/doi/10.1302/0301-620X.108B5.BJJ-2025-0858.R2/pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://boneandjoint.org.uk/doi/pdf/10.1302/0301-620X.108B5.BJJ-2025-0858.R2","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"588-596","type":"journal-article","issue":"5","score":1,"title":["Total hip arthroplasty compared with conservative treatment with a self-directed exercise 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Finland"}]}],"issued":{"date-parts":[[2026,5,1]]},"member":"42","prefix":"10.1302","source":"Crossref","volume":"108-B","created":{"date-time":"2026-05-01T00:01:23Z","timestamp":1777593683000,"date-parts":[[2026,5,1]]},"indexed":{"date-time":"2026-05-04T07:34:41Z","timestamp":1777880081109,"date-parts":[[2026,5,4]]},"license":[{"URL":"https://boneandjoint.org.uk/TDM","start":{"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000,"date-parts":[[2026,5,1]]},"delay-in-days":0,"content-version":"tdm"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://boneandjoint.org.uk/doi/10.1302/0301-620X.108B5.BJJ-2025-0858.R2"}},"subtitle":[],"assertion":[{"name":"published","group":{"name":"publication_history","label":"Publication 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rehabilitation protocols may not be representative of broader practice.","value_numeric":null},{"paper_doi":"10.1302/0301-620x.108b5.bjj-2025-0858.r2","tag_type":"warning","value":"The 38% crossover rate from the exercise arm to THA introduces significant contamination that may inflate the apparent benefit of THA in an intention-to-treat analysis. Per-protocol results are not separately reported in the abstract.","value_numeric":null}],"summaries":{"what_studied":"Single-centre RCT comparing THA plus postoperative rehabilitation vs. a self-directed exercise programme in 120 adults with moderate-to-severe hip OA (Kellgren-Lawrence grades 2–4); primary outcomes were WOMAC and Harris Hip Score (HHS) change at 12 months.","key_result":"At 12 months, THA produced a 27.1-point greater improvement in WOMAC (95% CI −32.4 to −21.8) and a 24.1-point greater gain in HHS (95% CI 19.6 to 28.7) vs. exercise alone — both exceeding predefined MCIDs. THA also outperformed exercise on all physical performance tests and most RAND-36 domains. Notably, 38% of the exercise group crossed over to THA during the study.","limitations":"Single-centre design limits generalisability. High crossover rate (38%) in the conservative arm may underestimate the true effect of exercise. Blinding of participants was not feasible given the nature of the interventions.","practice_takeaway":"For eligible patients with moderate-to-severe hip OA, THA delivers clinically meaningful gains in pain, function, and quality of life that a self-directed exercise programme alone cannot match at 12 months. Clinicians should counsel patients that exercise may be insufficient long-term, with a substantial proportion likely to require surgery within a year."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Joint Arthroplasty"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Joint Arthroplasty"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Joint Arthroplasty"}}}]]

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