Background and purpose: Hip Osteoarthritis is the most common joint disease and a major contributor to pain, decreased physical function and decline in health-related quality of life. Manual Therapy is one therapeutic approach to treating hip osteoarthritis. However, the efficiency of this therapeutic is still unclear. The objective of this systematic review and meta-analysis was to explore the effects of manual therapy on pain, physical function and quality of life in hip osteoarthritis.

Relevance: To reveal the best evidences regarding the effectiveness of manual therapy for managing hip osteoarthritis.

Methods: This systematic review protocol was managed according to the guidelines supplied by the PRISMA. The search on electronic databases was performed from October 2017 to June 2019 in PubMed, PEDro and the full Cochrane Library. Only Randomized Control Trials were selected. Randomized Control Trials were included if they had a score of Pedro ≥ 6. The selected Randomised Controlled Trials compared manual therapy to the placebo, no treatment or other usual conservative therapy. Outcomes were pain, activity of daily life and quality of life. Study selection, data extraction, and methodological quality assessment were conducted by two reviewers independently.

Analyse: The PEDro scale was used to evaluate the methodological quality of Randomised Controlled Trials. The strength of evidence from the selected studies was determined by GRADE and the effect size was calculated and used to assess the clinical relevance of manual therapy interventions in outcome measures. A meta-analysis was conducted to compare manual therapy to different control intervention. A random-effect model was applied, and forest-plots were drawn to illustrate the meta-analysis results. Heterogeneity was assessed with I² statistics and interpreted according to the Cochrane Handbook.

Results: Six studies involving six hundred and eleven hip osteoarthritis patients were included. Five studies ranked as high methodological quality (PEDro score ≥ 6/10) and high or moderate level (GRADE I or II). This review revealed that few studies have shown the positive effects of manual therapy on patients' pain, physical function and quality of life. Meta-analysis didn’t find strong evidence in favour to manual therapy on pain, function and quality of life after three months post intervention.

Conclusion: This review did not show strong evidence of manual therapy for the management of hip osteoarthritis.

Implications: Manual therapy is an emerging therapeutic alternative in the treatment of hip osteoarthritis patients. More quality studies on large cohorts are needed to determine on manual therapy would have an additional effect in hip osteoarthritis.

Keywords: Hip Osteoarthritis, Manual Therapy.

Funding Source Acknowledgement: No funding source

Ethicals approval: No Ethicals approval required for this review.