HIP OSTEOARTHRITIS (OSTEOARTHRITIS OF THE HIP JOINT)

Inflammation, injuries or aging may cause cartilage tissue to break down that causes development of hip osteoarthritis. Stiffness, rigidity, pain when walking are hip OA symptoms. Hip osteoarthrosis treatment depends on the severity of OA symptoms, as well as on the stage of joint damage, because if in the beginning, only a mild discomfort may appear and it possibly can be fixed with conservative treatment options; but as disease progresses, a person may start to have troubles walking and to relieve the condition, a hip replacement surgery may be needed. Let us talk in more details about treatment options and causes of hip coxarthrosis development below.

When you have arthritis, your body joints such as knees or hips, are inflamed and making you feeling a lot of pain. Out of the many different types of arthritis, osteoarthritis (OA) is the one that affects the most people. OA is also commonly called degenerative joint disease or age-related arthritis because osteoarthritis is more likely to appear when people age. Hip osteoarthritis occurs when inflammation and injury to a hip joint cause cartilage tissue to break down. This breakdown will cause irritation, inflammation, and deformity in your affected joint. Cartilage consists mainly of water and proteins. It forms steady and flexible material that protects the edges of your bones in normal joints.
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One of the main contribution of cartilage is to absorb the shock and minimize friction in the joints when any joint movements are made. Thanks to its high water content, your normal cartilage has the ability to transform its shape when being compressed. Therefore, normal cartilage becomes the natural layer of shock-absorbing protection between joints. Regardless of the repairs when cartilage is damaged, our human body is not able to develop new cartilage after the cartilage suffers from any damages. If you have osteoarthritis of the hip, you may sometimes struggle to walk. Patients may experience joint pain in different locations such as the groin, thigh, knee or buttocks. The pain can be sharp and sudden with apparent stiffness in the hip. Due to the locations of the painful sensation being so scattered, it can be challenging to diagnose osteoarthritis of the hip in the beginning.

HIP OA SYMPTOMS

Usually, hip osteoarthritis symptoms progress slowly over a period of time. Several OA symptoms and signs you should look out for are:

  • Reduced mobility
  • Joint stiffness
  • Crackling sensation
  • Stiffness in hips
  • Pain in groin or thigh that shoots to your buttocks or your knees
  • Pain, which breaks out severely after/ with any kind of active efforts
  • Bone spurs

HIP OSTEOARTHROSIS TREATMENT OPTIONS

At the moment, hip osteoarthritis cannot be completely reversed. However, you are still able to manage your symptoms through:

  • Physical therapy: Specially designed physical exercise program can help to increase your flexibility with improved range of motion in your affected joint. After participating in this program, the muscles in your hip and leg will become stronger.
  • Medications: When the level of pain increases and becomes intolerable, you may not be able to perform your daily routine as normal. Certain tasks that may be your routine in the past, such as walking, getting in and out of chairs, driving and lifting objects just to name a few will cause you excruciating pain. Your doctor will first explore other non-surgical treatments that may help to reduce your pain. However, if other non-surgical treatments could not relieve your pain, your doctor may assess the right medication prescription to complement your existing hip osteoarthrosis treatment plan.
  • Acetaminophen: An over-the-counter painkiller that can help to reduce mild level of pain for arthritic patients. However, all medications including this over-the-counter pain relief medication can cause side effects.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): There are two types of NSAIDS: over-the-counter NSAIDs and prescription-only NSAIDs. Over-the-counter NSAIDs include naproxen and ibuprofen. Both of these types of NSAIDs may help to reduce pain level and relieve inflammation in your joints.
  • Corticosteroids: This medication is also commonly called cortisone.  It is a very strong anti-inflammatory agent that works effectively. You can consume the medication by mouth or inject cortisone directly into your affected joint.

When the non-surgical treatment options fail to help you, you may want to discuss following hip osteoarthrosis treatment options with your doctor:

  • Cortisone injections: Cortisone injections may help to reduce pain in your affected joint. However, the medication used in the injections can speed up the joint damages over time.
  • Lubrication injections: Hyaluronic acid is a lubricating substance commonly found in your joint fluid. It allows the joint movements to be smooth without friction. Due to the thinning of hyaluronic acid in the arthritic patient’s joint fluid, the level of friction in between your bones at the affected joint will increase. While these injections offer pain relief by providing cushioning in your hip, some research has suggested that they offer no more relief than placebos.
  • Realigning bones: Your bone above or below your joint will be cut open and a wedge of your bone will be removed or added into the gap to help realign your bone structure. This will also help to reduce the weight supported by your affected joint. This procedure is especially helpful if hip osteoarthritis has significantly affected one side of your hip joint more than the other.

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  • Arthroplasty (Total hip joint replacement) A surgical way of hip osteoarthrosis treatment, where your surgeon replaces your affected joint surfaces with artificial joint implants made out of plastic and metal parts. Just like all surgeries, this procedure presents surgical risks such as infections and blood clots. The material of your artificial joint implants will experience normal wear and tear over time. Therefore, after a certain period of time, your artificial joints will start wearing out or loosening. You will then need a new artificial joint implant to be put in place.standard hip replacement surgery will be carried out under general anesthesia. Anesthesia is important in making sure that you do not feel any pain or have any awareness of the procedure. An alternative to general anesthesia is a spinal anesthetic.

    When performing the procedure, first an incision will be made along the side of your hip to expose the hip joint that is located at the top of your thighbone. Next, with the aid of a surgical saw, thighbone will be cut and the rolling ball portion of the hip joint will be removed. Your surgeon will then use medical cement or special adhesive material, to attach a new artificial joint to your thighbone. With the new artificial joint in place, any affected cartilage from the surface of the hipbone will be removed and an artificial socket implant will be attached to the hipbone. The artificial ball implant of the thighbone will then be fit into the socket implant of the hip. Your surgeon may also install a drain to remove any fluid from your hip. Lastly, your muscles will be reattached to your joints before your surgeon completes the procedure.

    These days, a lot of hip joint replacement procedures follow the standard protocol of making an eight to ten inch incision along the side of the hip. However, some surgeons have been pursuing an even more minimally invasive protocol.

     

    In this modern alternative, your surgeon will make maximum two incisions between two to five inches long. Through these smaller incisions, your surgeon will complete the exact procedure as the standard hip joint replacement procedure through these smaller openings. Due to the smaller openings, this will reduce the loss of blood and minimize post-surgery pain.

    Patients who underwent the hip replacement surgery would have shorter length of stay in the hospital with the application of this new operating method. Patients will be more pleased with much smaller scars and quicker recovery of the incision.

    However, this modern alternative invites controversy because the result of the surgery is highly dependent on the level of experience and skills of the surgeon. Therefore, it is crucial to have your surgery conducted by a highly experienced and skilled surgeon.

    Study shows that the recovery of the patient of this minimally invasive approach conducted by a less experienced surgeon, could be much less optimal than the standard hip joint replacement surgery with larger cuts. Just like any other surgeries, hip replacement surgery also poses health risk to the patient. You could lose blood and require blood transfusion during the surgery. So you may want to donate your own blood or ensure that compatible blood donors available before the surgery.

RECOVERY TIME FOR A TOTAL HIP REPLACEMENT

  • Normally, you will take around three to five days to recuperate in the hospital after the surgery.After leaving the hospital, you will need another three to six months to fully recover from the hip replacement surgery. The speed of recovery is highly dependent on your overall health, the progress of your rehabilitation and the type of surgery you undertake.
  • Before you leave the hospital, you are strongly advised to obtain post-surgery and rehabilitation guidance from your doctor. If you would like to have successful and speedy recovery, you should commit to follow the instructions the best you can when you are recovering at home.

DIAGNOSING HIP OSTEOARTHRITIS

  • History taking and physical exam: Your doctor will go through your symptoms and medical history with you during your appointment. He or she will need to perform a physical examination around your knee to better understand your condition. During this physical examination, your doctor will look for symptoms such as:
    • Inflammation or redness around your affected hip
    • Tenderness of the hip
    • Range of assisted and self-directed joint motion
    • Level of instability of the joint
    • Crackling sensation inside the joint during hip movement
    • Level of pain when additional weight is felt on your hip
    • Issues with your walk and movements
    • Any possible injury surrounding the affected joint
    • Any signs of rheumatoid arthritis
  • X-ray: Cartilage loss can be detected by a narrowing of space between your joints. However, your cartilages don’t show up on X-ray. This examination can also detect any presence of bone spurs around your joints.
  • Magnetic Resonance Imaging (MRI) scans: Radio waves and strong magnetic field are used to obtain images of bone and soft tissues in exquisite detail. MRI is not normally needed to diagnose this condition but it can be helpful in providing more information for complicated cases.
  • Blood tests: A blood test may be ordered when there is a need to exclude other conditions that might be causing your joint pain. One of these conditions could be rheumatoid arthritis, which is an immune system condition and a totally different type of arthritis causing inflammation of the lining of your joints.