THE CURRENT ISSUE · VOL. I · № 14 · 19 MAY 2026
When Surgery Outperforms Strength Training
Rethinking Severe Hip Osteoarthritis Through the PROHIP Trial
By Kamil R. Jarjess · Editorial Board, Conversations In Orthopaedics · 11 min read
A New England Journal of Medicine randomized controlled trial compared total hip replacement with supervised resistance training in patients with severe hip osteoarthritis. At six months, arthroplasty produced clinically meaningful and superior improvements in patient-reported hip pain and function — while the data simultaneously sharpened the case for conservative management, preoperative conditioning, and shared decision-making.
This issue analyses the trial design, the chosen endpoints, and the limits of inference — and then asks the question that matters in clinic: for whom, and when. An editorial reading, not a verdict.