Hip OA

Question 1

What are the diagnostic criteria to classify OA

Answer 1

1. Over age 50
2. Moderate anterior/ lateral hip pain during weight bearing
3. Morning stiffness < 1 hour
4. Hip IR < 24 deg, or IR and flexion 15 deg < non- painful side
5. increased hip pain with passive IR

Question 2

What outcome measures should you consider for hip pain and OA

Answer 2

1. WOMAC
2. BPI (brief pain inventory)
3. PPT (pain pressure threshold)
4. VAS (visual analog scale)

Question 3

What activity limitation and participation restriction outcome measures should you consider for OA?

Answer 3

1. WOMAC
2. HOOS (Hip Disability and Osteoarthritis Outcome Score)
3. LEFS (Lower Extremity Functional Score)
4. HHS (Harris Hip Score)

Question 4

What physical performance measures should you perform with persons with hip OA

Answer 4

1. 6 Min walk test
2. 30 sec chair to stand
3. TUG
4. Self paced walk
5. Timed SLS
6. 4 square step test
7. Step test

Question 5

What physical impairment measures should you perform for hip OA

Answer 5

1. FABER

2. MMT and ROM of IR/ ER/ flexion/ extension/ abduction/ adduction

Question 6

What patient education should be included with patients with hip OA

Answer 6

Combined with exercise/ manual therapy-

activity modification, exercise, supporting weight reduction when overweight, methods of unloading arthritic hip

Question 7

What manual therapy interventions should be included in treatment of hip OA

Answer 7

thrust, nonthrust, and soft tissue mobilization, adding in exercises to augment/ sustain gains in ROM, flexibility, and strength
MWM group had the highest benefit in pain, increased ROM, and self paced walking (level I evidence)
Can do anterior/ posterior joint mobilizations or lateral glides

Question 8

What recommendation can be made about U/S and hip OA treatment

Answer 8

B evidence- may use 1 mhz, 5 min to each anterior, lateral, and posterior musculature- 10 treatments over 2 weeks (5 days/ week) for short term management of pain

Question 9

What recommendations can be made about bracing

Answer 9

F evidence- Shouldn’t use as first line of treatment but may consider if other treatment is unsuccessful

Question 10

What recommendations can be made about weight loss in patients with hip OA

Answer 10

Refer out to physician, nutritionist, dietician

Question 11

What is the prevalence for hip OA

Answer 11

.4-27%, higher in females than males, but higher radiographic evidence for males

Question 12

what pathoanatomical features may increase risk for developing hip OA

Answer 12

Acetabular retroversion, developmental dysplagia, Cam deformity, h/o SCFE or FAI

Question 13

what are the risk factors for hip OA

Answer 13

Age 
Hip developmental disorders 
Previous hip injury 
Lower hip IR 
Male sex 
Higher BMI 
High poverty 
Lower education 
Higher bone mass

Question 14

What position should hip IR/ ER ROM or MMT be tested in

Answer 14

Prone (both ROM and MMT) 
or sitting (ROM)

Question 15

What are the recommendations on supplements for hip OA

Answer 15

Insufficient evidence to support glucosamine, chondroitin, hyaluronic acid