Chiropractic management of the kinetic chain for the treatment of hip osteoarthritis: An Australian case series

Objective: Osteoarthritis is the most common musculoskeletal disorder, estimated to affect 3 million Australians. Previous studies support structured exercise programs and manipulation for hip osteoarthritis; however, no trials have examined treatment of the lower limb kinetic chain. The purpose of this case series was to report hip range of motion and pain scale outcomes in 4 patients diagnosed with hip osteoarthritis who were treated with chiropractic management of the lower limb kinetic chain. Methods: Four subjects (mean age 59.5; SD ± 6.7) were provided with 9 sessions of chiropractic treatment. This included long-axis traction pulls and pre/post adjustment stretching of the symptomatic hip, with additional manipulation and mobilization of the lumbar spine, sacroiliac, knee, and ankle joints. Outcome measures included range of motion as measured and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: All 4 subjects had improvements in WOMAC scores, with a mean group reduction of 382.5 (SD ± 115.8) and overall improvement of 68.1%. As a group, there were improvements in internal rotation (51.7%, mean 7.3°; SD ± 6.2°), adduction (26.7%, mean 5.3°; SD ± 5.0°), abduction (21.1%, mean 6.8°; SD ± 5.4°), flexion (15.3%, mean 15°; SD ± 4.8°) and external rotation (8.5%, mean 8.5°; SD ± 6.0°). Conclusions: Four patients diagnosed with hip osteoarthritis had decreases in WOMAC scores and increases in hip range of motion after chiropractic management. Further research in the form of large scale randomized controlled trials is needed to investigate the effectiveness and clinical significance of chiropractic management for hip osteoarthritis.