Hip Arthritis

What is Osteoarthritis of the Hip?

Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage). In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint. Although osteoarthritis may affect various joints including hips, knees, hands, and spine, hip joint is most commonly affected. Rarely, the disease may affect the shoulders, wrists and feet.

Causes of Osteoarthritis of the Hip

Osteoarthritis is characterized by damaged articular cartilage, cartilage lining the hip joint. Advanced age is one of the most common reasons for osteoarthritis of the hip. You may also develop osteoarthritis if you had a hip injury or fracture in the past, if you have family history of osteoarthritis, suffering from hip diseases such as avascular necrosis and other congenital or developmental hip diseases.

Symptoms of Osteoarthritis of the Hip

The characteristic symptoms and diagnostic test help in diagnosing the condition. You will experience severe pain confined to hip and thighs, morning stiffness and limited range of motion. Based on the symptoms, your orthopaedic surgeon will perform a physical examination, X-rays and other scans, and some blood tests to rule out the other conditions that may cause similar symptoms.

Diagnosis

Doctors diagnose arthritis with a medical history, a physical exam and X-rays of the affected part. Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are also performed to diagnose arthritis.

Management of Osteoarthritis of the Hip

There are several treatments and lifestyle modifications that can help you ease your pain and symptoms.

• Medications: Pain-relieving medications such as NSAIDs, COX-2 inhibitors and opioids may be prescribed. Topical medications such as ointments can be applied over the skin where there is pain. If the pain is very severe, corticosteroid injection can be given directly into the affected joint to ease the pain.
• Other treatments: Your physiotherapist will teach you exercises to keep joints flexible and improve muscle strength. Heat/cold therapy which involves applying heat or cold packs to the joints provides temporary pain relief. Lifestyle modifications can be done to control weight and avoid extra stress on the weight-bearing joints.
• Surgery: Hip joint replacement surgery is considered as an option when the pain is so severe that it affects your ability to carry out normal activities. There are different surgical procedures that can be used and may include:
• Synovectomy: This surgery is usually indicated for early cases of inflammatory arthritis where there is significant swelling (synovitis) that is causing pain or is limiting the range of motion. Synovectomy is a surgical removal of the inflamed synovium (tissue lining the joint). The procedure may be performed using arthroscopy.
• Arthroplasty: In this procedure, your surgeon removes the affected joint and replaces it with an artificial implant. It is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis, post-traumatic arthritis or avascular necrosis. The goal of the surgery is to relieve pain and restore the normal functioning of the joint. Total joint replacement can be performed through an open or minimally invasive approach.
• Arthrodesis: A fusion, also called an arthrodesis, involves removal of the joints and fusing the bones of the joint together using metal wires or screws. This surgery is usually indicated when the joints are severely damaged, when there is limited mobility, damage to the surrounding ligaments and tendons, failed previous arthroplasty, and when heavy manual use is expected.

Your surgeon will discuss the options and help you decide which type of surgery is the most appropriate for you.