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Delay Hip Replacement Surgery with Exercise?

Everybody knows somebody who has gone under the knife for a hip replacement.  A family member, friend, co- worker, or even a gym buddy, chances are that someone you know has already undergone or been told they need a hip replacement.  With a US population that is living longer, struggling through an obesity epidemic, and demanding more from our bodies, our joints are breaking down just as we are starting to hit our prime older years.  Degenerative diseases such as Osteoarthritis are becoming significantly more prevalent in the aging baby-boomer generation, causing huge demand for hip surgery.  In fact, the American Academy of Orthopedic Surgeons estimates that primary total hip replacements will increase by 174% by the year 2030.  As of now, we can’t reverse cartilage damage or a degenerated joint, and surgery may be inevitable to regain quality of life in the future. But, the question I raise to this aging population is, “What can you do to postpone your hip replacement surgery?”

 A recent article in Orthopedics This Week highlighted a recent study published out of Oslo University Hospital, which points to exercise as a probable method for delaying hip replacement surgery.  The study examined 109 patients (mean age of 58) with X-ray confirmed Osteoarthritis of the hip joint.  The study showed that patients who underwent an exercise educational program along with an exercise program had a 44% decrease in the need for hip replacement surgery in comparison to patients who underwent exercise education alone.  The exercise program consisted on 2-3 days per week of exercise designed to promoted strength and flexibility.

Unfortunately, due to severity of symptoms and degeneration, some patients in the study inevitably needed a hip replacement surgery. However, the exercise group illustrated a median time to surgery of 5.4 years, while the non-exercise group had surgery much earlier at a median time of 3.5 years.   Furthermore, of the patients that did not undergo surgery, the patients in the exercise group illustrated a higher 6-year “survival rating” of the arthritic hip than the non-exercise group.  The article concluded, “ that exercise therapy enhances the survival of the native hip and is therefore important for healthcare consumption and for patients who may avoid surgery and its potential complications”.

As medical research continues to expand, regenerative cellular therapies, also known “Orthobiologics”, are exhibiting much potential as a main stay in treatment of degenerative joint diseases, and could have contributory effects to a consistent exercise program.   Orthobiologics such as Platelet Rich Plasma and Bone Marrow Concentrate have illustrated vast potential in the management of pain and stiffness with Osteoarthritis and may be a potential adjunct therapy to exercise for postponing hip replacement surgery.  Although further research and clinical trials are needed to explore the efficacy of such Orthobiologic therapy, existing research suggests a promising future!

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