HIP OSTEOARTHRITIS IN PRIMARY HEALTH CARE: CONSERVATIVE MANAGEMENT STRATEGIES, CURRENT EVIDENCE, AND CHALLENGES IN CHILE

Abstract

Introduction: Hip osteoarthritis is a common degenerative disease that can cause pain, functional limitation, and deterioration in quality of life. Primary Health Care plays a fundamental role in its initial diagnosis, conservative treatment, and follow-up. Objective: To review the current evidence on the main conservative management strategies for hip osteoarthritis in Primary Health Care and to analyze the main challenges associated with their implementation in the Chilean context. Methodology: A narrative review of the literature was conducted through searches in PubMed/MEDLINE and SciELO, complemented by official documents from the Chilean Ministry of Health. Systematic reviews, meta-analyses, clinical trials, and relevant studies addressing diagnosis, therapeutic exercise, education, weight control, pharmacological treatment, injections, and the organization of primary care were prioritized. Results: The evidence supports a multimodal management approach based primarily on therapeutic exercise, self-management education, and modification of risk factors, including weight control when appropriate. Nonsteroidal anti-inflammatory drugs may contribute to symptomatic control in selected patients, while intra-articular corticosteroid injections may provide short-term relief. In Chile, the integration of rehabilitation services into Primary Health Care represents a relevant strategy for expanding access, although challenges remain regarding resource availability, continuity of care, and coordination with specialized care. Conclusions: The management of hip osteoarthritis in Primary Health Care should prioritize non-pharmacological interventions and an individualized, multimodal approach. Strengthening rehabilitation, patient education, and coordination between Primary Health Care and specialized care may contribute to improving the timeliness and continuity of care in Chile.