What is the Rate of Response to Nonoperative Treatment for Hip-Related Pain? A Systematic Review With Meta-analysis.

Most participants were recruited from tertiary-care surgical clinics, so the findings may not generalise to patients first seen by a general practitioner or a community physical therapist. Treatment protocols varied widely across studies in content, duration, and supervision level, making it impossible to isolate the effect of any single component or to run meta-regression. Many included studies were single-arm or pilot RCTs with small samples; the certainty of evidence ranged from moderate (response rate) to very low (injections, bracing). Two of the largest RCTs in this area could not be included in the meta-analyses because the authors did not provide error terms, so the pooled estimates may be slightly under-estimated. The definition of 'response' differed across studies (no surgery, global rating of change, or reaching PASS), which adds heterogeneity to the 54% pooled figure. No studies evaluated oral medications, psychological interventions, or orthobiologic injections outside an operative setting, so the evidence base for these options is absent rather than negative.

The authors report no financial disclosures or conflicts of interest. None of the funding sources were involved in the study conduct or interpretation of results.

Do not quote the 54% response rate to a patient as a fixed probability. The confidence interval runs from 32% to 76%, the studies used different definitions of response, different treatment protocols, and different follow-up periods, so the number is a rough average across very different clinical situations. Also, the 11.3 point hip-function gain is a pooled average across heterogeneous protocols; it does not mean any specific exercise programme will produce that result.