Hip Arthritis
Osteoarthritis (OA) is the most common type of hip arthritis, affecting more than 32 million Americans. Hip arthritis is the leading cause of disability among older individuals. It usually affects people over the age of 50. However, younger patients aged 40-45 with hip deformities can experience early onset of hip OA. Arthritis affects the entire joint.
The hip joint is a ball and socket joint. The upper end of the thigh bone (femur) is called the femoral head, it is the ball that fits into the socket (the acetabulum) in the pelvis. The ball and the socket are lined with cartilage that allows the joint to glide easily and offers a wide range of motion.
Hip osteoarthritis is a degenerative joint disease that causes inflammation and deterioration of the cartilage that cushions the ends of the bones in the hip joint. As the cartilage begins to break down, the underlying bone changes and slowly worsens with time causing formation of bone spurs, and inflammation of the joint.
When the articular cartilage is damaged it narrows the joint space allowing the bones to rub against each other causing pain in the groin, pain that worsens with prolonged standing or walking, stiffness, swelling, audible crackling when moving the hip and loss of normal joint function. Restricted motion results in muscle weakness and worsens symptoms. In addition to pain and physical dysfunction, many patients experience symptoms including depression and anxiety, altered sleep, chronic widespread pain, and impaired coping skills.
The causes are complex and not well understood. However, these factors can increase your risk for developing hip arthritis, including:
- Age: The risk for hip arthritis increases with age
- Gender: Women are more likely to develop hip arthritis than men
- Obesity: Being overweight or obese can increase the wear and tear on the hips and lead to arthritis
- Joint injuries: Joint injuries increase the risk for developing arthritis later in life. (post-traumatic osteoarthritis)
- Repetitive stress: Jobs or activities that involve repetitive stress on the hips can increase the risk for developing arthritis
- Family history: Having a family member with arthritis can increase your risk for developing the condition
- Some bone deformities such as hip dysplasia
- Diseases like diabetes, metabolic syndrome and hypertension have been linked to osteoarthritis
You COS clinician will inquire about your symptoms and review your medical history to evaluate your risk factors. They will perform a physical exam testing range of motion, and may include checking for warmth, redness, tenderness, and swelling. Â Imaging studies, such as X-rays, MRIs, or CT scans, may be used to look for damage to the cartilage or bones, and narrowing of the joint space. Blood tests may also be done to check for inflammation or other conditions that can cause arthritis-like symptoms.
At the Center for Orthopaedic Specialists we offer a comprehensive plan for management of your hip arthritis. Treatment options depend on the severity of your condition, your personal preferences and you medical status.
Conservative management may be recommended to improve muscle strength, relieve pain, and allow a patient to avoid or delay surgery. The cornerstone of OA management includes:
- Exercise includes walking, strengthening, aquatic exercise. The majority of patients would benefit from some form of exercise to improve pain and function.
- Weight loss is strongly recommended to improve symptoms and function.
- Oral and topical anti-inflammatory (NSAIDs) medications.
- Intraarticular joint injections of steroids, hyaluronic acid, and platelet rich plasma can help provide pain relief.
- Tai Chi is effective to improve strength, balance and fall prevention as well as depression.
- Assistive devices such as a cane or walker.
- Cognitive behavior therapy is helpful to address chronic pain, quality of life, mood and fatigue, and disability.
- Acupuncture is effective for pain relief.
Hip replacement surgery
Joint replacement may be recommended for people with advanced hip arthritis who suffer from hip joint pain and structural damage that substantially interferes with daily activities, and for which other treatments have been exhausted.
Hip replacement surgery may involve replacing the head of the thighbone, and the socket with metal and plastic or ceramic implants. Another option is resurfacing the hip socket and capping the head of the thighbone with metal.
It typically takes several months to fully recover from a total hip replacement. The first few weeks will likely involve the most discomfort as you heal and adjust to your new hip. During this time, you may need help with activities like bathing and dressing. You may also need to use a wheelchair or walker.
Most people start to feel better after a few weeks, and many are able to return to their normal activities by six months. It may take up to a year to get back to all your pre-surgery activities and reach your full potential.
Osteotomy
This is surgery for young patients with hip deformities and hip joint injuries. It involves cutting and reshaping the hip joint bones to correct the problem.
When you or a loved one suffers with a painful hip it is important to see an orthopedic specialist. Early treatment can delay or avoid surgery, relieve pain, and improve function.
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