Therapeutic approaches for hip osteoarthritis: an integrative review of conservative and surgical treatments

Abstract

Objective: This study aimed to analyze the most used treatments for hip osteoarthritis (HOA), comparing conservative management and surgical intervention, particularly total hip arthroplasty (THA). The research sought to evaluate the effectiveness, limitations, and clinical applications of both approaches, emphasizing their impact on pain management, functional improvement, and disease progression. Methodology: This study followed an integrative literature review approach, analyzing 22 peer reviewed studies published between 2015 and 2025. The databases PubMed, Scopus, Web of Science, ScienceDirect, and SciELO were searched using specific keywords. Inclusion criteria consisted of studies that focused on non-surgical and surgical treatments for HOA, including NSAIDs, viscosupplementation, physical therapy, rehabilitation strategies, and total hip arthroplasty. Articles were evaluated using the Critical Appraisal Skills Programme (CASP) to ensure methodological rigor. Results: The findings demonstrated that conservative treatment is effective in mild to moderate HOA cases, providing temporary symptom relief and functional maintenance. NSAIDs and opioids (Ulusoy & Kıvrak, 2023) [31] were effective for pain control, while

viscosupplementation improved joint lubrication (Sousa et al., 2022) [28]. Additionally, physical therapy and cognitive rehabilitation enhanced mobility and neuromuscular adaptation (Linnhoff et al., 2025) [18]

. However, conservative treatment becomes less effective as the disease progresses, often requiring surgical intervention. Total hip arthroplasty (THA) was identified as the gold standard for severe HOA, offering long-term pain relief, biomechanical correction, and improved quality of life (Cohen et al., 2020) [10]. Advancements in prosthetic materials and minimally invasive techniques have contributed to faster recovery and longer implant durability (Santoso et al., 2018)[27] . Conclusion: The study confirms that conservative management should be prioritized in the early stages of HOA, while THA remains the most effective solution for end-stage cases. Spinopelvic biomechanics, patient-specific conditions, and functional demands must be considered in treatment decisions. Future research should focus on enhancing conservative treatments to prolong joint function, improving prosthesis materials, and optimizing post-surgical rehabilitation strategies to ensure better outcomes.