Not a phrase that is used much in orthopaedic surgery, although we are getting better at using treatments that are supported by a stong evidence base.

A recent summary from the American Academy of Orthopaedic Surgeons (AAOS) is helpful. Here are some of the findings:

• Glucosamine doesn’t work
• Obese people don’t achieve the same functional outcome as non-obese, but they have the same levels of satisfaction and pain relief
• Depression and anxiety have negative effects on outcome in all respects (pain relief, function, quality of life)
• Physiotherapy before surgery is helpful if you have mild to moderate symptoms, and it might help to improve the outcome of surgery
• Steroid injections improve function and relieve pain in the short term in patients with symptomatic arthritis of the hip. Hyaluronic acid injections are useless!

Any questions? Please get in touch!!