Hip Osteoarthritis

//Hip Osteoarthritis
Hip Osteoarthritis 2018-01-11T10:37:42+00:00

What Is Hip Osteoarthritis?

Osteoarthritis is a degenerative type of arthritis that affects millions of people in the United States. Osteoarthritis can affect any joint in the body. It most commonly develops in the weight-bearing joints of the body, such as the hip. The hip is one of the largest joints in your body. It’s known as a ball and socket joint.

The acetabulum, which is formed by the large pelvic bone, forms the “socket.” The femoral head forms the “ball.” Further, the surface of the hip joint is covered by synovial fluid. This serves to lubricate the joint and helps with movement.

If you’re suffering from osteoarthritis, the cartilage in your hip joint had begun to wear away. When that happens, the joint space begins to decrease. If degeneration is severe, bone can rub against bone. This results in severe arthritis pain within the joint.  Furthermore, the damaged bones may try to compensate for the loss of cartilage by growing outward. This can lead to bone spurs forming.

What is osteoarthritis of the hips? 

Symptoms Of Osteoarthritis

Osteoarthritis develops slowly, and progressively worsens over time.

Patients with this condition most commonly complain about pain and tenderness around the hip joint. They may also report that the pain is worse in the morning or after prolonged sitting. The quality of pain differs as well. Some patients describe the pain as a sharp, stabbing type pain, while others report a dull, aching type pain. Additional symptoms include:

  • Groin pain that radiates to the buttock or knee
  • Pain the worsens with strenuous activity
  • Hip joint stiffness
  • Inflammation around the hip joint
  • Hip joint locking or grinding
  • Decreased hip joint range of motion

At times, these symptoms can make it difficult to even walk or climb stairs. And, unfortunately, this results in the inability to perform normal activities of daily living. Osteoarthritis in the hips is a serious concern. Here’s what we know about what leads to it.

Hip Osteoarthritis Causes

There are no specific causes of hip arthritis; however, several risk factors have been identified. These increase an individual’s risk of developing this condition. Risk factors include:

  • Increasing age
  • Obesity
  • Previous hip joint injury
  • Congenital deformities (i.e. hip dysplasia)
  • Family history of osteoarthritis
  • Co-morbidities (i.e. diabetes, gout, rheumatoid arthritis)

Getting A Diagnosis

If you suffer from pain in your hips, locking, or stiffness, it’s time to talk to a doctor. They can help diagnose the condition and suggest treatments that do work.

If you have symptoms, your doctor will usually start by taking a detailed health history. This includes:

  • Past medical history
  • Family history
  • A history of the current pain episode

Additionally, your doctor will perform a physical exam. During this, they’ll look for:

  • Joint tenderness
  • Gait abnormalities
  • Decreased range of motion
  • Joint crepitus
  • Signs of muscle, tendon, or ligament damage around the hip joint

Once you’ve undergone these preliminary tests, your doctor may order additional ones. They may order an X-ray that can visualize the hip joint structure, looking for joint space narrowing, bone changes, and bone spur formation. In complicated cases, magnetic resonance imaging (MRI) can further visualize bone and soft tissue damage.

Together–health histories, physical exams, and advanced imaging techniques–can lead to a diagnosis. You can’t treat a condition until you know for sure what’s causing it. Once a diagnosis is confirmed, your doctor can put together a treatment plan that reduces your symptoms.

Hip Osteoarthritis Treatment

There is no cure for osteoarthritis in the hips. The goals of treatment are to reduce pain and improve mobility. Your treatment plan will differ depending on how much pain you’re experiencing and how much the condition has progressed.

Early treatment plans

For many who only have early stages of osteoarthritis in the hips, lifestyle modifications can drastically reduce symptoms. Surgery is often an unnecessary risk. Early hip joint arthritis lifestyle modifications may include:

  • Weight loss
  • Minimizing exposure to activities that increase hip pain
  • Switching from high-impact exercise (i.e. running) to low-impact exercise (i.e. swimming)
  • The use of assistive devices, including canes and walkers, to help improve mobility

Alternative treatment options, including physical therapy and chiropractic care, can help you maintain and possibly improve joint range of motion. These therapists use mobilization or manipulation of the hip joint and surrounding structures to reduce pain. Further, a physical therapist can develop an exercise program to help improve your range of motion and strength in the affected area.

There are also medications that help with more moderate osteoarthritis. Your doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDs) as a first-line therapy. You know these medications as aspirin or ibuprofen.

NSAIDs help to relieve inflammation, which may help to relieve associated pain. However, NSAIDs can also cause stomach upset, cardiovascular problems, bleeding issues, as well as liver and kidney damage. Acetaminophen may also be prescribed to relieve mild to moderate osteoarthritis pain. However, taking high doses of acetaminophen has been linked to liver damage.

If you’re taking medication to relieve your pain, work closely with your doctor. Make sure they monitor all side effects. Follow their directions exactly for use.

Advanced treatment plans

Some people suffer from advanced or severe osteoarthritis. For these people, lifestyle modifications will help, but not as effectively. Many need additional treatment.

Talk to your doctor if lifestyle modifications haven’t helped. They may suggest hip injections to start. Minimally-invasive, corticosteroid injections directly into the hip joint can decrease inflammation within the joint. This can help reduce pain. Additionally, injections of hyaluronic acid may also be recommended to help reduce joint pain. Hyaluronic acid is a lubrication medication that is similar to a component that is naturally found in joint fluids.

The following video shows a similar type of joint injection procedure.

Hip surgery

If your pain is unresponsive to conservative treatment options, your doctor may ultimately recommend surgery. Surgery is typically only recommended when other, less-invasive measures have been shown not to work. There are a few hip surgery approaches, including:

  • Osteotomy
  • Hip resurfacing
  • Hip replacement surgery

An osteotomy is a procedure that is rarely used; it involves realigning either the femoral head or acetabulum to take pressure off of the hip joint.

Hip resurfacing involves removing the damaged bone and cartilage in the acetabulum and replacing it with a metal shell. The femoral head is not removed; it is capped with a smooth metal covering. This procedure allows for a total hip replacement to be performed in the future, if necessary.

Total hip replacement surgery involves removing both the damaged acetabulum and femoral head and replacing them with metal, plastic, or ceramic joint surfaces in an attempt to recreate the joint and restore normal joint function.

Complications of hip joint surgery involve:

  • Infection
  • Bleeding
  • Blood clots
  • Blood vessel damage
  • Hip dislocation
  • Limb length discrepancy

Because of these complications, it’s always important to work closely with a highly-trained surgeon. Make sure they’ve worked extensively with hip surgeries. Ask them any questions or concerns you have, before the procedure takes place.

Conclusion

Osteoarthritis is a common, degenerative type of arthritis. It most commonly affects the weight-bearing joints of the body, including the hip.

Patients often experience joint pain, stiffness, and inflammation. Most patients only have mild symptoms. However, osteoarthritis in the hips can become severe and impact your ability to perform normal activities. When that happens, it’s time to get help.

There are various effective treatment options available. These range from conservative treatment options such as lifestyle modifications and anti-inflammatory medications, to joint injections, and lastly surgery. Patients suffering from this condition should speak with their physicians about the various treatment plans that are available to help manage their pain.

To find a pain specialist in your area, click the button below. They’ll be able to diagnose your condition and suggest treatments that work.

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References

  1. Atchia I, Kane D, Reed MR, Isaacs JD. Birrell F. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis. Ann Rheum Dis. 2011;70:110-116.
  2. Ganz R, Parvizi J, Beck M, Leunig M, et al. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clinical Orthopaedics & Related Research. 2003;417:112-120.
  3. Jacobsen A, Sonne-Holm S. Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey. Rheumatology. 2005;44(2):211-218.
  4. Lohmander LS, Gerhardsson de Verdier M, Rollof J, Nilsson PM, Engstrom G. Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study. Ann Rheum Dis. 2009;68:490-496.
  5. Pourbagher MA, Ozalay M, Pourbagher A. Accuracy and outcome of sonographically guided intra-articular sodium hyaluronate injections in patients with osteoarthritis of the hip. JUM. 2005;4(10):1391-1395.
  6. Zhang W, Doherty M, Arden N, Bannwarth B, et al. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR standing committee for international clinical studies including therapeutics (ESCISIT). Ann Rheum Dis. 2005;64:669-681.

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