Hip Osteoarthritis in General Practice: Course and Therapies

Osteoarthritis of the hip is a common problem in todayâ?Ts aging society. The disease is characterised by joint pain and functional limitations. The treatment of osteoarthritis has been focused on relief of symptoms, since there are as yet no therapies available that can alter progression of the disease. In the last decade the search for a disease modifying treatment has been intensified. One of the most promising agents is glucosamine sulphate. Results on pain were conflicting, when tested in patients with knee osteoarthritis. Our randomised controlled trial (GOAL) was the first trial to assess the effect of glucosamine on symptoms and structural progression of primary care patients with hip osteoarthritis. We found that there was no difference in effect between glucosamine and placebo on pain (-1.54 [-5.43, 2.36]), function (-2.01[-5.38, 1.36]), or joint space narrowing (-0.029 [-0.122, 0.064]). Also, no significant differences were found in any of the predefined subgroups based on radiographic severity or type of osteoarthritis. We also looked at the course of complaints of patients with hip osteoarthritis over two years. We assessed pain and function every three months and found that while complaints on average stayed relatively stable over 2 years, the intraindividual pain level was highly fluctuating. Seventy percent of all patients with hip osteoarthritis had consulted one or more care givers for their complaints. The costs for medical consumption is estimated to be â,¬639 per patient per year, which is comparable to costs for knee osteoarthritis. The majority of these costs were attributable to total hip replacement by an orthopedist.

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