Responders to Exercise Therapy in Patients with Osteoarthritis of the Hip: A Systematic Review and Meta-Analysis.

Lotte Hermsen,Sita M.A Bierma-Zeinstra,Jos Runhaar,Ingrid B De Groot,Elja A.E Reijneveld,Marienke Van Middelkoop,Carolien H Teirlinck,Arianne P Verhagen,Leontien M Van Ravesteyn

doi:10.3390/ijerph17207380

Abstract

The Outcome Measures in Rheumatology workgroup (OMERACT), together with the Osteoarthritis Research Society International (OARSI) developed the OMERACT-OARSI responder criteria. These criteria are used to determine if a patient with osteoarthritis (OA) ‘responds’ to therapy, meaning experiences a clinically relevant effect of therapy. Recently, more clinical OA trials report on this outcome and most OA trials have data to calculate the number of responders according to these criteria. A systematic review and meta-analysis were performed on the response to exercise therapy, compared to no or minimal intervention in patients with hip OA using the OMERACT-OARSI responder criteria. The literature was searched for relevant randomized trials. If a trial fit the inclusion criteria, but number of responders was not reported, the first author was contacted. This way the numbers of responders of 14 trials were collected and a meta-analysis on short term (directly after treatment, 12 trials n = 1178) and long term (6–8 months after treatment, six trials n = 519) outcomes was performed. At short term, the risk difference (RD) was 0.14 (95% confidence interval (CI) 0.06–0.22) and number needed to treat (NNT) 7.1 (95% CI 4.5–17); at long term RD was 0.14 (95% CI 0.07–0.20) and NNT 7.1 (95% CI 5.0–14.3). Quality of evidence was moderate for the short term and high for the long term. In conclusion, 14% more hip OA patients responded to exercise therapy than to no therapy.

Highlights

Hip osteoarthritis (OA) is common cause of disability
We performed a review about the effect of exercise therapy in hip and knee OA, the flowchart shows the references of knee OA during the beginning of the selection process, see Figure 1
At short term the percentage of responders was 30% in the exercise group and 16% in the control group (RD = 0.14, 95% confidence interval (95% CI) 0.06–0.22, number needed to treat 7.1, 95% CI 4.5–17)

Summary

Introduction

Hip osteoarthritis (OA) is common cause of disability. In the Netherlands 18.8 out of 1000 men and 33.3 out of 1000 women suffer from hip OA (prevalence in 2018). Osteoarthritis is the tenth cause of Disability Adjusted Life Years (DALY’s) in the Netherlands. The economic cost of osteoarthritis in 2017 in the Netherlands was 433.4 million euros, which is 1.4% of total health cost, of which hip OA is the second cause (knee OA is the first) [1]. Res. Public Health 2020, 17, 7380; doi:10.3390/ijerph17207380 www.mdpi.com/journal/ijerph

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