Hip Arthritis

FAQs on Hip Arthritis

 

Hip arthritis affects about 28 percent of all osteoarthritis patients aged over 45. Over 300,000 hip total and partial replacements are performed in the United States every year. More than 35% of all arthritis-associated procedures are related to knee and hip implants.

What is hip arthritis?

Hip arthritis onsets as inflammatory disorder starts affecting the hip joints. The cartilage cushioning bones at the hip joint began deteriorating with age, injury, and various other reasons. This leads to bones rubbing with each other as the joint performs a range of motions. As a result, you experience stiffness and pain in the hip preventing many of performance of day-to-day activities.

Hip arthritis can be classified into various types.

  • Osteoarthritis or arthritis due to wear and tear of the cartilage
  • Rheumatoid arthritis or inflammation in the synovial lining
  • Systemic lupus erythematosus or autoimmune disorder affecting hip cartilage
  • Psoriatic arthritis associated with psoriasis skin disorder

What are the symptoms of hip arthritis?

  • Hip joint pain and stiffness
  • Pain impacting buttocks, groin, and thigh
  • Worsening pain and stiffness as you wake up in the morning
  • Walking problem
  • Restricted activity due to hip pain or stiffness
  • Pain aggravates with extended or intensive activity
  • Hip stiffness after you stand up following rest
  • Hip joint swelling or tenderness
  • Pain worsens in rainy and winter months

How does hip arthritis occur?

The hip is a “ball-and-socket” joint, where the femoral head fits into the acetabulum. A thick layer of slippery tissues known as cartilage covers the bone heads. Like a shock observer, it cushions the femoral head and the acetabulum, prevents them coming into direct contact with each other, and facilitates their smooth movements. Synovium, a thin lining covering the joint, releases a type of fluid that keeps the cartilage lubricated.

When the cartilage wears away with age, it becomes thin and rough. This allows bones to rub with each other as the protective space between them narrows down due to the lost cartilage. Patients experience pain and stiffness in the joint that increase with formation of bone spurs. Friction of bones forces enhances inflammatory disorder and hip arthritis sets in.

What are the main causes of hip arthritis?

  • Hip joint cartilage degeneration with age
  • Traumatic injury to the hip joint
  • Obesity and overweight
  • Genetic osteoarthritis
  • Congenital hip dysplasia disorder
  • Repeated stress and strain on the hip
  • Rheumatoid arthritis
  • Repeated stress more than the knee joint able to withstand
  • Bone spurs in the hip joint
  • Gout or uric acid deposition

Who are at the risk of hip arthritis?

Women face higher risk of hip arthritis. The threat also increases with age and sedentary lifestyle. Hip arthritis is also hereditary and you are at risk if your family members suffer from it. Diabetes and gut deposition also assist the disorder.

How is hip arthritis diagnosed?

Physical examination: Doctors check patients for symptoms, such as

  • Pain and tenderness in the hip
  • Ability to perform passive and active movements without pain
  • Grating sound in the hip joint
  • Area of pain when the hip is pressurized
  • Potential gait problems
  • Injury to hip muscles and ligaments

Doctors may suggest x-ray and MRI tests to identify injury to the hip joint bones, formation of spurs, and the condition of the cartilage.

What are the treatment methods available for hip arthritis?

  • Medications: NSAID are prescribed to reduce inflammation and pain. There are also drugs to prevent progress of psoriatic and rheumatoid arthritis to the acute stage.
  • Self-Care:
  • Change your sedentary lifestyle
  • Lose weight
  • Icing, acupuncture, and other conservative treatments
  • Regular exercises
  • Avoiding activities that may aggravate the condition
  • Switching to less stressful activities
  • Enhancing hip flexibility
  • Using assistive devices
  • Surgery of the Hip Joint
  • Osteotomy: Surgical removal of bone surface on the femoral head or the acetabulum and realignment to ensure that the hip joint does not face excessive pressure and both bones rub with each other.
  • Hip Resurfacing: Damaged bone and cartilage in the hip socket are removed and a metal shell is inserted in their place. The femoral head is also covered with smooth metal covering to reduce friction.
  • Total hip Replacement: The entire “ball-socket joint” is removed and replaced by metal, plastic or ceramic joints.
  • Pain Management Injections:
  • Cortisone injections: Steroid directly injected to the joint reduces inflammation and pain and allows better mobility for months at a time.
  • Anesthetic injections: Lidocaine, a local anesthetic, inhibits pain and swelling for weeks at a time and helps improve mobility.
  • Lubricant injections: Hyaluronic acid when injected lubricates the cartilage and makes the rough surface slippery again. Lubricated cartilage makes the hip joint movable without friction and pain.
  • Prolotherapy or PRP/ Stem Cell injections: Stem cells and platelet-rich plasma when injected to the hip joint, it helps in regeneration of the cartilage. Degenerated and damaged parts of the cartilage are replaced with new cells through body’s own healing mechanism.

References

Arthritis Foundation

American College of Rheumatology

National Institute of Arthritis and Musculoskeletal and Skin Diseases

American Academy of Orthopedic Surgeons (AAOS)

Arden N, Nevitt MC. Osteoarthritis: Epidemiology. Best Pract Res Clin Rheumatol. 2006;20(1):3-25. doi: 10.1016/j.berh.2005.09.007.

Bennell KL, Hinman RS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport. 2011;14(1):4-9. doi: 10.1016/j.jsams.2010.08.002.

Rodney S. Van Pelt. Hip Arthritis Prolotherapy Injection Technique. Journal of Prolotherapy. Volume 1 : Issue 2 : May 2009

Kellgren JH. Osteoarthritis in patients and populations. Br Med J. 1961;Vol 2.:1-6.

Murray RO. The aetiology of primary osteoarthritis of the hip. Br J Radiol. Nov 1965;38(455):810-24.

Zgoda M, Paczek L, Bartlomiejczyk I, Sieminska J, Chmielewski D, Górecki A. Age-related decrease in the activity of collagenase in the femoral head in patients with hip osteoarthritis. Clin Rheumatol. Feb 2007;26(2):240-1.

Valdes AM, Spector TD. Genetic epidemiology of hip and knee osteoarthritis. Nat Rev Rheumatol. Jan 2011;7(1):23-32.

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