¿Cuál Es el Tratamiento de Primera Línea para la Artrosis de Cadera?
La artrosis de cadera se maneja según múltiples guías clínicas principales, que convergen en un enfoque estructurado de primera línea. Este protocolo refleja las recomendaciones de dichas guías y abarca una serie de estrategias no farmacológicas con niveles de evidencia moderados a sólidos.
Enfoque Terapéutico
El protocolo incluye programas de educación y autogestión junto con ejercicio estructurado, entre otras modalidades respaldadas por evidencia. El régimen completo, incluidos los criterios de selección y la secuencia de cada componente, está disponible a través del enlace a continuación.
References
DOI: 10.1016/j.rdc.2022.03.009.
- All guidelines made moderate to strong recommendations for education and self-management as part of OA management.
- Patients with OA should be advised to engage in regular low impact aerobic exercise (land or aquatic-based) and to lose weight if overweight.
- Balance training was conditionally recommended for knee and hip OA in the ACR/AF guidelines, and neuromuscular training, which includes balance, agility, and coordination exercises, was recommended for knee OA by AAOS.
- Tai chi was strongly recommended for knee and hip OA by ACR/AF and for knee OA by OARSI (also conditionally recommended for hip and polyarticular OA by OARSI).
- Thermal modalities were strongly recommended for hip OA by OARSI (conditionally not recommended for knee and polyarticular OA) and conditionally recommended by ACR/AF for knee, hip, and/or hand OA.
- Walking aids (e.g., canes, crutches) were generally recommended as needed for knee and hip OA, with moderate to high quality of evidence for use of canes.
- Acupuncture was conditionally recommended for patients with knee, hip, and/or hand OA in the ACR/AF guidelines despite limited evidence, given the positive effect of acupuncture for analgesia and low risk of harm.
- Cognitive behavioral therapy (CBT) was conditionally recommended for patients with knee, hip, and/or hand OA by ACR/AF on the basis of data regarding chronic pain management, although further study is needed to better assess the benefit of CBT in OA directly.