Abstract

Purpose: To investigate the effect of a personalised, home-based, biomechanical foot-worn device on the referral rates for secondary care amongst patients with Hip Osteoarthritis (OA) who meet the clinical criteria for joint replacement.

Methods: One hundred and fifty-seven patients with hip OA participated in a commercial programme by Circle Integrated Care (CIC) offering innovative musculoskeletal rehabilitation services and pathway management. Patients were calibrated with a foot-worn biomechanical device that re-distributes loads via centre of pressure manipulation and generates perturbation to train proprioception. Patients are personally calibrated based on their gait profile and symptoms, then receive a home-based treatment plan that typically includes daily wear for 30-60 minutes while going about daily activities. Patients were reassessed clinically after six months, 1, 2 and 3 years. A mixed linear model was used to examine clinical changes over time.

Results: There were thirty-one (19.7%) referrals for secondary consultation. The mean days to referral was 310.5 (SD=273.8) days. 67% of all referrals occurred during the first year of treatment. Significant improvements were calculated for all clinical outcomes.

Conclusion: The results of the study suggest a significant clinical improvement among patients who failed core therapies and meet the criteria for joint replacement, with over 80% of the patients avoiding it for at least three years. This intervention should be considered as an additional non-surgical option for patients with hip OA who meet surgical criteria for joint replacement.