Osteoarthritis of the Hip

Osteoarthritis is sometimes called “wear-and-tear” arthritis, osteoarthritis is a common condition that many people develop during middle age or older. It can occur in any joint in the body, but most often develops in weight-bearing joints, such as the hip.

Osteoarthritis of the hip causes pain and stiffness. It might be difficult to do routine activities like taking a short walk, getting up from a chair, or bending over to tie your shoelaces

Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely it is that we can lessen its impact on your life. Although there is no cure for osteoarthritis, there are many treatment options to help you manage pain and stay active.

Anatomy

The hip is one of the body’s largest joints. It is a “ball-and-socket” joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone).

The bone surfaces of the ball and socket are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones and enables them to move easily.

The surface of the joint is covered by a thin lining called the synovium. In a healthy hip, the synovium produces a small amount of fluid that lubricates the cartilage and aids in movement.

In osteoarthritis, the cartilage in the hip joint gradually erodes over time. As the cartilage wears away, it becomes frayed and rough, and the protective joint space decreases. This can result in bone grating against bone. To make up for the lack of cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes)

Cause

Osteoarthritis has no single specific cause, but there are certain factors that may make you more likely to develop the disease, including:

• Increasing age
• Family history of osteoarthritis
• Previous injury to the hip joint
• Obesity
• Improper formation of the hip joint at birth, a condition known as developmental dysplasia of the hip

Even if you do not have any of the risk factors listed above, you can still develop osteoarthritis.

Symptoms

The most common symptom of hip osteoarthritis is pain around the hip joint. Usually, the pain develops insidiously and worsens over time, although sudden onset is also possible. Pain and stiffness may be worse in the morning, or after sitting or resting for a while. Over time, painful symptoms may occur more frequently, including during rest or at night. Additional symptoms may include:

• Pain in your groin or thigh that radiates to your buttocks or your knee
• Pain that flares up with vigorous activity
• Stiffness in the hip joint that makes it difficult to walk or bend
• “Locking” or “sticking” of the joint, and a grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip
• Increased joint pain during cold weather.

Treatment

Although there is no cure for osteoarthritis, there are a number of treatment options that will help relieve pain and improve mobility.

Nonsurgical Treatment

As with other arthritic conditions, early treatment of osteoarthritis of the hip is nonsurgical. Your surgeon may recommend a range of treatment options.

At Surrey Total Health we strongly advocate modifying your lifestyle. Some changes in your daily life can protect your hip joint and slow the progress of osteoarthritis.

• Minimising activities that aggravate the condition, such as climbing stairs.
• Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your hip.
• Losing weight can reduce stress on the hip joint, resulting in less pain and increased function.

Physiotherapy

Specific exercises can help increase range of motion and flexibility, as well as strengthen the muscles in your hip and leg. Your surgeon will help you develop an individualised exercise for hip arthritis program that meets your needs and lifestyle.

Medication

If your pain affects your daily routine, or is not relieved by other nonsurgical methods, your surgeon may add medication to your treatment plan.

• Paracetamol is an over-the-counter pain reliever that can be effective in reducing mild arthritis pain. Like all medications, however, over-the-counter pain relievers can cause side effects and interact with other medications you are taking. Be sure to discuss potential side effects with your surgeon.
• Non-steroidal anti-inflammatory drugs (NSAIDs) may relieve pain and reduce inflammation. Over-the-counter NSAIDs include naproxen and ibuprofen. Other NSAIDs are available by prescription.
• Corticosteroids (also known as cortisone) are powerful anti-inflammatory agents that can be taken by mouth or injected into the painful joint.

Surgical Treatment

Your surgeon at Surrey Total Health may recommend surgery if your pain from arthritis causes disability and is not relieved with nonsurgical treatment.

Hip resurfacing

In this hip replacement procedure, the damaged bone and cartilage in the acetabulum (hip socket) is removed and replaced with a metal shell. The head of the femur, however, is not removed, but instead capped with a smooth metal covering.

Total hip replacement

Your surgeon will remove both the damaged acetabulum and femoral head, and then position new metal, plastic or ceramic joint surfaces to restore the function of your hip.

Complications

Although complications are possible with any surgery, your surgeon will take steps to minimise the risks. The most common complications of surgery include:

• Infection
• Excessive bleeding
• Blood clots
• Hip dislocation
• Limb length inequality
• Damage to blood vessels or arteries

Recovery

After any type of surgery for osteoarthritis of the hip, there is a period of recovery. Recovery time and rehabilitation depends on the type of surgery performed.

Your surgeon may recommend physiotherapy to help you regain strength in your hip and to restore range of motion. After your procedure, you may need to use a cane, crutches, or a walker for a time.

In most cases, surgery relieves the pain of osteoarthritis and makes it possible to perform daily activities more easily.