Osteoarthritis of the Hip

Osteoarthritis of the hip is frequently referred to as a “wear-and-tear” disease. The cartilage of the hip joint progressively wears away over many years, causing stiffness and pain. Osteoarthritis can make it challenging to do everyday activities like getting up out of a chair or even walking.

Given that osteoarthritis slowly worsens over time, the sooner you start treatment, the more likely it is that you can reduce its impact on your life. Sadly, there is no cure for osteoarthritis, but many non-surgical and surgical treatment choices are available to help you manage the pain and stay active.

Anatomy

The hip is comprised of a ball and socket joint. The large pelvic bone shapes the socket and the ball is shaped by the upper end of the thighbone. The slippery tissue known as the articular cartilage protects the joint’s surface, producing a smooth surface that permits the bones to glide easily across each other. The large pelvic bone is ringed by strong fibrocartilage known as the labrum, which produces a lining around the socket.

The whole joint is surrounded by ligaments that form a shell that acts to hold the joint together. The shell’s undersurface is lined by a thin membrane, which produces synovial fluid to lubricate the hip joint.

Symptoms

Signs and symptoms of osteoarthritis include:

• Joint stiffness may be most noticeable after waking up or after being inactive.
• Affected joints may be painful during or after movement.
• The affected joint may feel tender when you apply light pressure to or near it.
• You may become less flexible and unable to move your joint through its full range of motion.
• You might sense a grating feeling when you use the joint, and you might hear popping or crackling.
• Extra bits of bone, called bone spurs, can form around the affected joint.
• You might experience swelling of the soft tissue around the affected joint.

When to see a doctor

If you are experiencing joint pain or stiffness that doesn’t stop, make an appointment with your physician.

Origins

Osteoarthritis happens when the cartilage that cushions the ends of bones in the joints progressively deteriorates. Ultimately, if the cartilage is worn down completely, bone will rub on bone and produce pain and stiffness.

Osteoarthritis affects the entire joint, besides causing the breakdown of cartilage. It produces a transformation in the bone and weakens the connective tissues that keep the joint together and attached muscle to bone. It also triggers inflammation of the joint lining.

Risk factors

• Issues that can increase your risk of osteoarthritis include:
• Studies have shown that women are more likely to develop osteoarthritis than men.
• The risk of osteoarthritis increases as we age.
• Being overweight is a factor for osteoarthritis in several ways, and the more a person weighs, the higher risk they are for having osteoarthritis. Additional weight adds stress to weight-bearing joints, such as the knees and hips. Also, fat tissue creates proteins that can produce harmful inflammation in and around the joints.
• Injuries to the joints, such as when playing sports or an accident, can raise the risk of osteoarthritis. Even injuries that occurred several years ago and outwardly healed can increase your risk of osteoarthritis.
• Repeated stress on the joint. If your job or a sport, you play places repetitive stress on a joint, that joint could develop osteoarthritis.
• Other family members may already suffer from osteoarthritis.
• Metabolic diseases, including diabetes and a condition in which your body has too much iron (hemochromatosis), can put you at a higher risk for developing osteoarthritis.
• Many people are born with abnormal joints or defective cartilage.

Diagnosis

The Orthopaedic Associates of St. Augustine physician will speak with you about your symptoms, overall health, and medical history. He will also perform a physical examination and imaging tests.

During the physical exam, your physician will search for:

• Any pain when pressure is placed on the hip.
• Indications of injury to the muscles, ligaments, and tendons surrounding the hip.
• Any issues with the way you walk.
• Tenderness in and around the hip.
• Decreased range of hip motion.
• A grating feeling inside the joint during movement.

Typically, the physician will order an x-ray. The X-rays generate detailed pictures of dense structures, such as bones. It should show if your hip joint space has narrowed and any other changes in the bone. It can also show the formation of any bone spurs. On occasion, an MRI scan, or CT scan, or a bone scan may be required to help determine the state of the bone and soft tissues of the patient’s hip.

Treatment Options

While there isn’t a cure for osteoarthritis of the hip, several treatment options can help relieve pain and improve mobility.

Non-surgical Treatment Options

There are many different non-surgical treatments your physician may recommend, including:

• Lifestyle modifications. You can make a few changes to your daily routine to help protect your hip joint and slow the progress of osteoarthritis. For example, minimize activities that aggravate the hip. These may include climbing stairs or switching from high impact activities like running or tennis to lower impact activities like cycling or swimming.
• Physical therapy. Particular exercises can increase the range of motion and flexibility while also improving the leg and hip muscles. Physical therapy can help you perform exercises that meet your needs and lifestyle.
• Medications. If your pain affects your daily routine, your Orthopaedic Associates of St. Augustine physician may add one of the following medications to your treatment plan: Nonsteroidal anti-inflammatory drugs like Advil (ibuprofen), Aleve (naproxen), cortisone (anti-inflammatory steroid) or Tylenol (acetaminophen).
• Assistive devices. Using walking supports like a cane or walker can improve mobility and independence.

Surgical Treatment

If non-surgical treatment is unsuccessful or your pain and symptoms are severe, your surgeon may propose a surgical procedure. There are several surgical procedures your physician may advise you, such as:

• During a hip resurfacing procedure, the damaged bone and cartilage in the hip socket are removed and replaced with a metal shell. Afterward, the head of the femur is covered with a smooth metal covering.
• An Osteotomy is a procedure that reduces the weight off the hip joint by cutting and realignment of the head of the thighbone or the socket.
• During a total hip replacement, the damaged acetabulum and femoral head are detached and replaced by either a new plastic, metal or ceramic joint.

No matter which surgical procedure is selected, it will take time to recover. While recovering, you will need physical therapy to help regain strength and restore range of motion. Following your surgery, you may require a cane, or a walker for a short time. Typically, surgery relieves osteoarthritis pain and makes it possible to perform daily activities with less difficulty.

Talk to your Orthopaedic Associates of St. Augustine physician to learn more about osteoarthritis of the hip.