Osteoarthritis of The Hip
Osteoarthritis is a very common form of arthritis that involves long-term degeneration of the joint – in this case the hip. Osteoarthritis usually occurs in patients of advanced age but can also occur in younger patients. Beyond wear and tear due to age and long-term high-impact activity, excess weight and obesity is a significant factor in the progression of osteoarthritis.
Osteoarthritis of the hip involves a degeneration of the cartilage within the joint. As the cartilage wears down and thins, it cannot provide the support and stability the joint needs to remain functional. The cartilage itself can become frayed and cause pain, while the bones within the joint can begin to rub on one another and form bone spurs, which only increase disability and pain.
Causes of Osteoarthritis of The Hip
Because osteoarthritis is a long-term degenerative disease, there is no single identifiable cause. Rather, a number of issues combine to increase the risk of the disorder. The most common causes of hip osteoarthritis are:
- Advanced age
- (Repeated) Injury to the hip
- Excess weight and obesity
- Congenital hip issues
- Family history of osteoarthritis
Symptoms of Hip Osteoarthritis
If you are feeling chronic pain in the hip area, this may be a sign of osteoarthritis in the hip joint. This pain can come on rather suddenly, but most of the time it occurs slowly over a period of years. It is important that you speak to a qualified specialist to ensure that the cause is indeed osteoarthritis and not another hip or groin issue that shares the same symptoms
The most common signs and symptoms of hip osteoarthritis include:
- Pain and stiffness that may be exacerbated when you are not in motion or when waking up in the morning
- Referred pain in the groin or thigh
- Difficulty moving the hip joint
- Locking of the joint
- Decreased range of motion in the hip
- Pain that worsens with significant activity or during humid weather
Diagnosing Hip Osteoarthritis
An important part of the diagnosis is ruling out any cooccurring hip disorders that may share the symptoms of osteoarthritis. Rheumatoid arthritis and injuries such as fractures can also cause similar symptoms and should be ruled out by an experienced orthopedic surgeon. A medical history and physical examination will start the diagnostic process. Range of motion issues, pain, injury to the muscles, tendons and ligaments around the hip and more will all be considered when making the diagnosis.
Diagnostic imaging such as x-rays can show joint space in the hip and whether bone spurs have formed. MRIs and CT scans are occasionally used if more information is required about the bone and soft tissue structures.
Treatment for Osteoarthritis
When caught early, the effects of osteoarthritis can be partially mitigated, although the condition cannot be reversed. If hip pain is mild to moderate, or if the patient is not a candidate for surgery, lifestyle modifications such as losing weight, avoiding high impact activities and improving diet can all help. Medications, such as anti-inflammatory drugs and oral steroids, assistive devices such as a cane or walker and physical therapy to strengthen the muscles around the hip may all be employed as well.
If conservative measures fail to slow the progression of osteoarthritis, you may be a candidate for surgery. There are several surgical procedures that can be considered. Which is best depends on the diagnosis and a conversation with your orthopedic surgeon about outcomes and risk.
A total hip replacement involves the replacement of both the ball and socket of the hip joint. This may be appropriate for patients with significant degeneration that want to get back to an active lifestyle. A partial hip replacement involves only the removal and replacement of the ball side of the joint. This can be considered for patients who expect to be less active in their lifestyle. Hip resurfacing involves the removal of bone and cartilage in the socket, replacing it with an implant, but keeping the ball intact and sometimes capping it with metal.
Prognosis for patients with osteoarthritis
Mild to moderate cases of hip osteoarthritis are usually managed well with conservative measures such as lifestyle change, medication, physical therapy and, sometimes, assistive devices. Patients may be able to slow or stop the progression of osteoarthritis and lead a normal life without much dysfunction and only occasional flareups of pain.
Severe degeneration usually leads to surgery in the form of a hip replacement – whether partial or total. While it may seem like a drastic option, modern hip replacement surgeries are successful and very safe. Patients are usually walking the day or surgery and are back to their normal activity within 4 to 6 weeks. Further, with good care, hip replacements can last upwards of 20 years or more.