The development of hip osteoarthritis: implications for conservative management

Hip osteoarthritis (OA) can be the result of a multitude of causes. There is some evidence to suggest that a dysfunction in the neuromuscular system may contribute to the development of hip OA, This article reviews the forces and loads at the hip joint and the different presentations of hip OA in order to present a hypothesis that the neuromuscular system can play a role in the development of hip OA. Changes in the neuromuscular system include alterations in gait patterns and changes in muscular synergies. An improved understanding of the role these factors may play in the development of hip OA provides a perspective to explore treatment rationales and to provide more effective conservative management. (C) 1999 Harcourt Publishers Ltd.