Osteoarthritis in the Hip
Introduction
Osteoarthritis is a type of arthritis caused by the breakdown and loss of cartilage of a joint. Research shows that almost 10 million Americans are affected by osteoarthritis. Individuals with a family history of the disease are more likely to be affected. Besides, individuals who are elderly, obese or have an injury that puts stress on the hip cartilage are more vulnerable to be affected by OA of the hip.
OA of Hip
Osteoarthritis of the hip is basically defined as a non-inflammatory degenerative disease of the hip joint, usually appearing in the late middle or old age. It is characterized by growth or maturational disturbances in the femoral neck and head.
Osteoarthritis is most common in weight-bearing joints of the body. Therefore, the hips are one of the most vulnerable areas prone to be affected by this disorder.
Articular cartilage, the smooth and glistening covering on the ends of the bones that help the hip joint glide, usually wear thin in this condition. In the worse stages of the osteoarthritis of hip, the hip joint gets stiff and inflamed and bone spurs usually build up at the edges of the joint. As the cartilage wears away completely, bones begin to rub directly against each other, making each movement highly painful. Further, the patient of the OA of the hip might lose the ability to rotate, flex or extend the hip.
The muscles controlling the joint get weak if the individual becomes less active in order to avoid the pain. Eventually, the individual suffering from OA of the hip might start limping in such cases.
The first sign is usually a bit of discomfort and stiffness. These sensations are most strongly felt in the groin, buttock or thigh, especially upon waking up in the morning.
The pain usually flares up when the individual becomes more active and gets better with rest.
Occurrence and Trends
OA of the hip affects an equal number of men and women. Though there are no prominent discriminations, yet OA of the hip usually affects Caucasians and rarely affects the Asian and African people.
In addition, women with nodal osteoarthritis of the hand and those in physically stressful occupations are at an increased risk of hip osteoarthritis.
In some cases, individuals with hip problems such as the Perthes’ disease at birth time or undiagnosed congenital dislocation at birth might also become a cause later.
Treatment Options
There are various lines of treatment followed for the cure of osteoarthritis of the hip, in accordance with the stage of the disease and the patient’s general health conditions. Here we briefly explain each of the treatment modalities.
1. First-line treatment
Upon the occurrence of symptoms or at the onset of the disease, the following measures are generally adopted as the first line of treatment:
- Immediate rest of the hip from overuse
- Physical therapy including gentle exercises such as swimming, water aerobics and cycling
- Adequate sleep
- Reduce consumption of alcohol
- Weight reduction
2. Conservative Treatment
Also known as the non-surgical form of treatment, the conservative treatment includes a variety of options. These are:
- Weight loss
- Activity modification/limitation
- Anti-inflammatory medication (NSAIDs), such as ibuprofen
- COX-2 inhibitors
- Supplements like glucosamine and chondoitin sulfate
- Cortisone injections
Hip Replacement Surgery
Total hip replacement surgery is usually recommended only in the later stages of osteoarthritis of the hip. In cases where the hip joint hurts excessively upon resting at night or when the hip becomes severely deformed, a hip replacement surgery or arthroplasty is generally performed.
In this surgery, the patient gets a two-piece ball and socket replacement for the hip joint, which is aimed at reducing the pain and improving the ability to walk. For some time after the surgery, you might need to use crutches or a walker. A procedure for hip replacement often relieves both, the pain in the hip as well as in the back.
In addition to total hip replacement, arthrodesis (fusion or fixation) is another form of surgery recommended for cure of OA of the hip. It is very important to follow a proper rehabilitation programme after a surgery in order to restore the hip’s flexibility and work the muscles back into shape.
