Osteoarthritis of the Hip


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What is osteoarthritis of the hip?

Osteoarthritis of the hip is a condition that involves the gradual degeneration of joints predominantly linked to ageing. Osteoarthritis of the hip causes the wearing away of the cartilage tissue, which in turn leads to an increase in joint friction, pain and swelling.

There are two recognised types of osteoarthritis - primary and secondary. Most osteoarthritis is primary and occurs without any specific cause, although in some cases it may run in families.

Secondary arthritis is caused by previous injuries or in some cases by other medical conditions such as psoriasis.

What causes osteoarthritis of the hip?

While an exact cause has not yet been attributed to osteoarthritis of the hip, there are factors which are understood to contribute to the condition. Ageing is considered to be the most influential of these factors. If you have had an injury to the hip joint, you are understood as being at more risk of developing osteoarthritis of the hip. Obesity is also considered a risk factor both from increased weight on the joint and the inflammation occurring in the joint driven by fat cells.

Among the other factors which can potentially increase risk are activities that put a strain on the knee or hip, inherited cartilage defects, and joints that haven't formed properly during childhood.

Symptoms of osteoarthritis of the hip

Symptoms of hip osteoarthritis, which warrant speaking to your doctor about, include; pain and tenderness in the hip joint; swelling in the hip joint; joint stiffness after sitting down for a long time; joint stiffness when getting up in the morning; a 'crunching' sensation when bones rub against each other; and restricted movement of the hip, which can make everyday activities more difficult.

Examining for osteoarthritis

As a first step, your doctor can conduct a physical examination, which may require you to perform actions that can indicate hip function and review your medical history. While there is no one test for diagnosing osteoarthritis of the hip, it is normal for an Xray to be used in order to confirm features such as narrowing of the joint and extra bone formation.

Treatment for osteoarthritis of the hip

Initially non-surgical treatments can be effective in treating osteoarthritis of the hip.  These include physiotherapy which is largely focused on building strength and enhancing flexibility; painkilling medication; losing weight, general exercise and a healthy lifestyle may help. Sometimes particular activities that aggravate the hip can be avoided and using a cane or other walking aid in order to avoid putting weight on the joint may help; and medications such as nonsteroidal anti-inflammatory drugs (NSAID), including ibuprofen.

When the hip osteoarthritis can no longer be managed with conservative measures surgery may be required.  Total hip replacement surgery is carried out to replace the worn ball and socket. This may take the form of hip resurfacing or hip replacement.

Hip resurfacing is indicated in younger males and recaps the femoral head with a metal cover and relines the socket with a metal socket made of cobalt/chromium.

Total hip replacement removes the femoral head and replaces it with a smaller ceramic or metal head fastened onto a stem that fits down the upper thigh (femur).  This may be held in place by cement or in some cases by a coating on the outside of the stem. The socket will be replaced either with a cemented cup made of a special plastic or a metal socket that bone grows into, which has a plastic or ceramic liner.

In some cases the surgeon may use a robot called MAKO to help in placing the cup and stem.

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