Minimizing the risk of total hip replacement is a good reason for patients with osteoarthritis (OA) to engage in exercise-based treatment, according to a long-term follow-up of a randomized trial. In patients with OA (n = 109) who received a combination of education and exercise therapy there was 41% survival of native hips after 6 years, compared with only 25% hip survival for individuals who only received patient education; importantly, the median time to total hip replacement was 5.4 years and 3.5 years, respectively.