Year 2020 / Volume 27 / Number 6


Effectiveness and current recommendation of manual therapy on hip osteoarthritis. An overview

Rev. Soc. Esp. Dolor. 2020; 27(6): 375-391 / DOI: 10.20986/resed.2021.3835/2020

Mathias Orellana, Juan José Valenzuela, Martín Díaz, Marjorie Gold, Juan Rubio


Introduction: Osteoarthritis (OA) is the most common joint disease, increases with age and it is estimated that in those over 60 years of age more than 80 % have OA in at least one joint. Currently, the evidence regarding manual therapy (MT) in hip OA has had unclear results. Therefore, the main objective of this study is to determine the effectiveness and recommendation of MT in the hip OA. And secondary objectives, (I) review the existing literature on the intervention of MT in hip OA, (II) calculate the effectiveness of MT techniques in hip OA and (III) determine if there are benefits after the MT intervention in hip OA.
Methods: A systematic search was carried out in electronic databases, in order to compile the available literature between the years 2000 and 2019, taking as reference the PRISMA statement for systematic reviews. Letters to the editor, bibliographic reviews and gray literature were excluded.
Results: After reviewing 30 articles, we included 7 RS and 14 RCTs. 7 RCTs measured pain intensity of OA in response to MT vs. a control group. 4 RCTs measuring pain intensity in hip OA using MT + exercises Seven RCTs measured function in subjects with hip OA in response to MT vs. CG. Two RCTs evaluated the effects of MT + Ex on function.
Discussion: Although the results were in favor of manual therapy, compared to the control group, these were not statistically significant, so we propose to carry out new primary studies to eliminate some biases in program execution and improve intervention in both groups.


Introducción: La osteoartritis (OA) es la enfermedad articular más frecuente, aumenta con la edad y se estima que en los mayores de 60 años más del 80 % tienen OA en, al menos, una articulación. Actualmente, la evidencia respecto a la terapia manual (TM) en la OA de cadera ha tenido resultados poco claros, por lo que el objetivo principal de este estudio es determinar la efectividad y recomendación de TM en la OA cadera. Los objetivos secundarios son: a) revisar la literatura existente sobre la intervención de TM en OA de cadera; b) calcular la efectividad de las técnicas de TM en OA de cadera, y c) determinar si hay beneficios después de la intervención de TM en OA cadera.
Métodos: Se realizó una búsqueda sistemática en bases de datos electrónicas, con el fin de recopilar la literatura disponible entre los años 2000 y 2019, tomando como referencia la declaración PRISMA para revisiones sistemáticas. Se excluyeron las cartas al editor, revisiones bibliográficas y literatura gris.
Resultados: Después de revisar 30 artículos, incluimos 7 RS y 14 ECA. 7 ECA midieron la intensidad del dolor de la OA en respuesta a TM vs. un grupo de control. 4 ECA que midieron la intensidad del dolor en la OA de cadera que usaban TM + ejercicios Siete ECA midieron la función en sujetos con OA de cadera en respuesta a TM vs. CG. Dos ECA evaluaron los efectos de TM + Ex en la función.
Discusión: Si bien los resultados estuvieron a favor de la terapia manual, en comparación con el grupo control estos no fueron estadísticamente significativos, por lo cual proponemos realizar nuevos estudios primarios para eliminar algunos sesgos en la ejecución del programa y mejorar la intervención en ambos grupos.

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1. Martínez R, Martínez C, Calvo R, Figueroa D. Osteoartritis (artrosis) de rodilla. Rev Chil Ortop Traumatol. 2015;56(3):45-51. DOI: 10.1016/j.rchot.2015.10.005 .
2. Kraus VB, Blanco FJ, Englund M, Karsdal MA, Lohmander LS. Call for standardized definitions of osteoarthritis and risk stratification for clinical trials and clinical use. Osteoarthritis Cartilage. 2015;23(8):1233-41. DOI: 10.1016/j.joca.2015.03.036
3. Salmon JH, Rat AC, Sellam J, Michel M, Eschard JP, Guillemin F, et al. Economic impact of lower-limb osteoarthritis worldwide: A systematic review of cost-of-illness studies. Osteoarthritis Cartilage. 2016;24(9):1500-8. DOI: 10.1016/j.joca.2016.03.012.
4. Nelson AE. Osteoarthritis year in review 2017: clinical. Osteoarthritis Cartilage. 2018;26(3):319-25. DOI: 10.1016/j.joca.2017.11.014.
5. Schoor NM, Zambon S, Castell MV, Cooper C, Denkinger M, Dennison EM, et al. Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: The European project on OSteoArthritis. Qual Life Res. 2016;25(6):1423-32. DOI: 10.1007/s11136-015-1171-8.
6. Iacobelli S. Artrosis y guías de tratamiento GES [Internet]. Sociedad médica de santiago; 2013. Disponible en:
7. Ministerio de Salud. Guía Clínica Tratamiento médico en personas de 55 años y más con artrosis de cadera y/o rodilla leve o moderada [Internet]. Santiago, Chile: Minsal; 2009. Disponible en:
8. Wieczorek M , Rat AC. Generalidades sobre la artrosis: epidemiología y factores de riesgo. EMC Aparato locomotor. 2017;50(3):1-12. DOI: 10.1016/S1286-935X(17)86066-4.
10. Birrell FN, Oliver S. Osteoarthritis in primary care. Pract Nurse. 2010;39(2):38-45.
11. Altman RD. Early management of osteoarthritis. Am J Manag Care. 2010;16(suppl management):S41-S47.
12. López Armada MJ, Carames B, Cillero Pastor B, Blanco FJ. Physiopathology of arthrosis: ¿What is the state of the art?. Rev Esp Reumatol. 2004;31(6):379-96.
13. Henak CR, Abraham CL, Anderson AE, Maas SA, Ellis BJ. Peters CL, et al. Patient-specifc analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia. Osteoarthritis Cartilage. 2014;22(21):210-7. DOI: 10.1016/j.joca.2013.11.003.
14. Henak CR, Carruth ED, Anderson AE, Harris MD, Ellis BJ, Peters CL, et al. Finite element predictions of cartilage contact mechanics in hips with retroverted acetabula Osteoarthritis Cartilage. 2013;21(10):1522-9. DOI: 10.1016/j.joca.2013.06.008.
15. Wyles CC, Heidenreich MJ, Jeng J, Larson DR, Trousdale RT, Sierra RJ. Te John Charnley Award: Redefning the Natural History of Osteoarthritis in Patients With Hip Dysplasia and Impingement. Clin Orthop Relat Res. 2017;475(2):336-50. DOI: 10.1007/s11999-016-4815-2.
16. Reijman M, Hazes JM, Pols HA, Koes BW, Bierma-Zeinstra SM. Acetabular dysplasia predicts incident osteoarthritis of the hip: the Rotterdam study. Arthritis Rheum. 2005;52(3):787-93.
17. Ryd L, Brittberg M, Eriksson K, Jurvelin JS, Lindahl A, Marlovits S, et al. Pre-Osteoarthritis: Defnition and Diagnosis of an Elusive Clinical Entity. Cartilage. 2015;6(3):156-65. DOI: 10.1177/1947603515586048.
18. Moo EK, Han SK, Federico S, Sibole SC, Jinha A, Abu Osman NA, et al. Extracellular matrix integrity afects the mechanical behaviour of in-situ chondrocytes under compression. J. Biomech. 20014;47(5):1004-13.
19. Haudenschild DR, Chen J, Pang N, Steklov N, Grogan SP, Lotz MK, et al. Vimentin contributes to changes in chondrocyte stifness in osteoarthritis. J Orthop Res. 2010;9(1):20-5. DOI: 10.1002/jor.21198.
20. Capín-Gutiérrez N, Talamás-Rohana P, González-Robles A, Lavalle-Montalvo C, Kourí JB. Cytoskeleton disruption in chondrocytes from a rat osteoarthrosic (OA) -induced model: its potential role in OA pathogenesis. Histol Histopathol. 2004;19(4):1125-32. DOI: 10.14670/HH-19.1125.
21. Osteoarthritis Research Society International. Osteoarthritis: A Serious Disease [Internet]. Osteoarthritis Research Society International; 2016. Disponible en:
22. Tang X, Wang S, Zhan S, Niu J, Tao K, Zhang Y, et al. The Prevalence of Symptomatic Knee Osteoarthritis in China: Results From the China Health and Retirement Longitudinal Study. Arthritis Rheumatol. 2016:68(3):648-53. DOI: 10.1002/art.39465.
23. Kodama R, Muraki S, Oka H, Iidaka T, Teraguchi M, Kagotani R, et al. Prevalence of hand osteoarthritis and its relationship to hand pain and grip strength in Japan: The third survey of the ROAD study. Mod Rheumatol. 2016;26(5):767-73. DOI: 10.3109/14397595.2015.1130673.
24. Deshpande BR, Katz JN, Solomon DH, Yelin EH, Hunter DJ, Messier SP, et al. Number of Persons With Symptomatic Knee Osteoarthritis in the US: Impact of Race and Ethnicity, Age, Sex, and Obesity. Arthritis Care Res (Hoboken). 2016;68(12):1743-50. DOI: 10.1002/acr.22897.
25. Bennell KL, Buchbinder R, Hinman RS. Physical therapies in the management of osteoarthritis: current state of the evidence. Curr Opin Rheumatol. 2015;27(3):304-11. DOI: 10.1097/BOR.0000000000000160.
26. Steultjens M, Dekker J, van Baar ME, Oostendorp R, Bijlsma JW. Range of joint motion and disability in patients with osteoarthritis of the knee or hip. Rheumatology (Oxford). 2000;39(9):955-61. DOI: 10.1016/j.ijpara.2009.01.002.
27. Steultjens M, Dekker J, Van Baar M, Oostendorp R, Bijlsma J. Muscle strength, pain and disability in patients with osteoarthritis. Clin Rehabil. 2001;15(3):331-41. DOI: 10.1191/026921501673178408.
28. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-74. DOI: 10.1002/acr.21596.
29. Cibulka MT, Bloom NJ, Enseki KR, Macdonald CW, Woehrle J, McDonough CM. Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2017. J Orthop Sport Phys Ther. 2017;47(6):A1-A37. DOI: 10.2519/jospt.2017.0301.
30. Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cartil. 2008;16(2):137-62. DOI: 10.1016/j.joca.2007.12.013.
31. Mendoza Castaño S, Noe Puig M, Mas Ferreiro R, Valle Clara M. Osteoartrosis. Fisiopatología y Tratamiento. Revista CENIC Ciencias Biológicas. 2011;42(2):81-88.
32. Beumer L, Wong J, Warden SJ, Kemp JL, Foster P, Crossley KM. Effects of exercise and manual therapy on pain associated with hip osteoarthritis: a systematic review and meta-analysis. Br J Sports Med. 2016;50(8):458-63. DOI: 10.1136/bjsports-2015-095255.
33. Sampath KK, Mani R, Miyamori T, Tumilty S. The effects of manual therapy or exercise therapy or both in people with hip osteoarthritis: A systematic review and meta-analysis. Clin Rehabil. 2016;30(12):1141-55. DOI: 10.1177/0269215515622670.
34. French HP, Brennan A, White B, Cusack T. Manual therapy for osteoarthritis of the hip or knee - A systematic review. Man Ther. 2011;16(2):109-17. DOI: 10.1016/j.math.2010.10.011.
35. Wang Q, Wang TT, Qi XF, Yao M, Cui XJ, Wang JJ, et al. Manual Therapy for Hip Osteoarthritis: A Systematic Review and Meta-analysis. Pain Physician. 2015;18(6):E1005-20.
36. Abbott JH, Robertson MC, Chapple C, Pinto D, Wright AA, Leon de la Barra S, et al. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness. Osteoarthritis Cartilage. 2013;21(4):525-34. DOI: 10.1016/j.joca.2012.12.014.
37. Poulsen E. Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial. Osteoarthritis Cartilage. 2013;21(10):1494-503. DOI: 10.1016/j.joca.2013.06.009.
38. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and metaanalysis of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ. 2009;339: b2700. DOI: 10.1136/bmj.b2700.
39. Higgins JPT, Green S (eds.). Manual Cochrane de revisiones sistemáticas de intervenciones. En: The Cochrane Collaboration [en línea]. 2011 [consultado el 10/10/2018]. Disponible en:
40. Bennell KL, Dobson F, Himann S. Exercise in osteoarthritis: moving from prescription to adherence. Best Pract Res Clin Rheumatol. 2014;28(1):93-117. DOI: 10.1016/j.berh.2014.01.009.
41. Fernandes L, Storheim K, Nordsletten L, Risberg MA. Development of a Therapeutic Exercise Program for Patients With Osteoarthritis of the Hip. Phys Ther. 2010;90(4):592-601. DOI: 10.2522/ptj.20090083.
42. Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J. Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Rheum. 2007;57(3):407-14. DOI: 10.1002/art.22621.
43. Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999;79(4):371-83.
44. Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS) – validity and responsiveness in total hip replacement. BMC Musculoskeletal Disorders. 2003;4:10. DOI: 10.1186/1471-2474-4-10.
45. Blackman F, Atkins E. The effect of adding grade B hip mobilization to a muscle strengthening home exercise programme on pain, function, and range of movement in adults with symptomatic early-stage hip osteoarthritis: A pilot study for a randomized controlled trial. Int Musc Med. 2014;36(2):54-63. DOI. 10.1179/1753615414Y.0000000029.
46. Brantingham JW, Parkin-Smith G, Cassa TK, Globe GA, Globe D, Pollard H, et al. Full Kinetic Chain Manual and Manipulative Therapy Plus Exercise Compared With Targeted Manual and Manipulative Therapy Plus Exercise for Symptomatic Osteoarthritis of the Hip: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2012;93(2):259-67. DOI: 10.1016/j.apmr.2011.08.036.
47. Hoeksma HL, Dekker J, Ronday HK, Heering A, Van Der Lubbe N, Vel C, et al. Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: A randomized clinical trial. Arthritis & Rheumatism. 2004;51(5):722-9. DOI: 10.1002/art.20685.
48. Romeo A, Parazza S, Boschi M, Nava T, Vanti C. Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review. Reumatismo. 2013;65(2):63-74. DOI: 10.4081/reumatismo.2013.63.
49. Sampath KK, Mani R, Miyamori T, Tumilty S. The effects of manual therapy or exercise therapy or both in people with hip osteoarthritis: a systematic review and meta-analysis. Clin Rehabil. 2016;30(12):1141-55. DOI: 10.1177/0269215515622670.
50. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end‐result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-55.

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Orellana M, Valenzuela J, Díaz M, Gold M, Rubio J. Effectiveness and current recommendation of manual therapy on hip osteoarthritis. An overview. Rev Soc Esp Dolor 2020; 27(6): 375-391 / DOI: 1020986/resed20213835/2020

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Recibido: 11/07/2020

Aceptado: 02/12/2020

Prepublicado: 22/01/2021

Publicado: 27/01/2021

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