Hochberg MC, Altman RD, Brandt KD et al.
Arthritis & Rheumatism, 1995;38:1535-1540

While there is no cure for osteoarthritis (OA) treatment that is individualized can help patients manage their disease. The goals of managing patients with OA of the hip are to control pain, minimize disability and education for both the patient and family members. Nonpharmacologic therapy includes patient education, participation in arthritis self-help programs, social support by means of telephone contact and the use of physical and occupational therapists. Exercise such as aerobic conditioning has also been shown to be effective. Those who are overweight should be encouraged to lose weight via the means of a weight management program. Pharmacologic therapy for pain relief has traditionally started with nonsteroidal anti-inflammatory drugs (NSAIDs). However, because of concerns about among other things the possible adverse effects on articular cartilage metabolism and the greater risk of toxicity from prolonged NSAID use in the elderly, NSAID use has been questioned. The recommended initial drug of choice is acetaminophen at doses up to 4,000 mg/day. If a patient does not respond to acetaminophen, then an NSAID is indicated. Opioid analgesics may be useful for short-term treatment. In some patients, intra-articular injections may be useful. Patients who have not responded to medical therapy should be referred for surgical evaluation for osteotomy and total joint arthroplasty.

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