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Aim  To describe the natural progression and the rates of arthroplasty of a cohort of hip and knee osteoarthritis ( OA ) patients.    Methods  An observational study of 247 consecutive patients who attended an  OA  clinic between May 2008 and August 2009. Follow‐up survey was conducted from July 2014 to December 2014, with the primary end point being joint replacement surgery.    Results  One hundred and sixty‐seven patients had knee  OA  and 80 patients had hip  OA . When adjusted for other variables (age, gender, body mass index, Kellgren‐Lawrence stage, symptom duration, presence of  OA  elsewhere and pain score), patients with hip  OA  demonstrated 86% increased hazard of surgery compared to knee  OA  patients (95%  CI  increase of 19% to 193%). At 6 years after initial consultation, 67% of patients with knee  OA  did not require a knee replacement surgery, while 40% (30, 51) of hip  OA  patients did not undergo surgery (95%  CI : 59–74%). Overall at 6 years, 58% of patients (95%  CI : 51–64%) did not undergo joint replacement surgery.    Conclusion  Knee and hip  OA  patients appear to behave differently, with hip  OA  patients more likely to undergo arthroplasty. There is a significant number of both hip  OA  and knee  OA  patients who did not require arthroplasty at the end of 6 years, suggesting a major role for conservative therapy.

international journal of rheumatic diseases

Differences in presentation, progression and rates of arthroplasty between hip and knee osteoarthritis: Observations from an osteoarthritis cohort study‐a clear role for conservative management