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Osteoarthritis of the Hip

Other popular names

Who does it affect?

Generally a condition associated with age, however it could be due to heredity factors, childhood conditions or injury.  Often people engaged in active sport may suffer with osteoarthritis as they get older.

10% of the population are affected by osteoarthritis.

Why does it happen?

Like other joints that carry your weight, your hips may be at risk for "wear and tear" arthritis (osteoarthritis), the most common form of the disease. The smooth and glistening covering (articular cartilage) on the ends of your bones that helps your hip joint glide may wear thin.

Osteoarthritis is a disease which affects joints in the body and the hip is one such joint.  The surface of the joint is damaged and the surrounding bone grows thicker. ‘Osteo’ means bone and ‘arthritis’ means joint damage and swelling (inflammation). Other words used to describe osteoarthritis are ‘osteoarthrosis’, ‘arthrosis’ and ‘degenerative joint disease’.

When a joint develops osteoarthritis, the cartilage gradually roughens and becomes thin, and the bone underneath thickens. The bone at the edge of the joint grows outwards (this forms osteophytes or bony spurs). The synovium swells slightly and may produce extra fluid, which then makes the joint swell slightly. The capsule and ligaments slowly thicken and contract, as if they were trying to stabilise the joint as it gradually changes shape. Muscles that move the joint may weaken and become thin or wasted.

When we look at osteoarthritic joints under a microscope, we see the joint is trying to repair itself. All the tissues of the joint are more active than normal. For example, new tissue is produced to try to repair the damage, such as the osteophytes. In many cases, especially in small finger joints, the repair is successful. This explains why many people have osteoarthritis but experience few or no problems. However, sometimes the repair cannot compensate for the damage. Osteoarthritis may then seriously affect the joint, making it painful and difficult to move. This occurs particularly in large joints such as the knees and hips.

Osteoarthritis is a slow process that develops over many years. In most cases there are only small changes that affect only part of the joint. Sometimes, though, osteoarthritis can be more severe and extensive.

In severe osteoarthritis, the cartilage can become so thin that it no longer covers the thickened bone ends. The bone ends touch and start to wear away. The loss of cartilage, the wearing of bone, and the bony overgrowth at the edges can change the shape of the joint. This forces the bones out of their normal position and causes deformity.

Symptoms

Your first sign may be a bit of discomfort and stiffness in your groin, buttock, or thigh when you wake up in the morning. The pain flares when you are active and gets better when you rest. Sleep disturbance and stiffness of the hip is common.

If you do not get treatment for osteoarthritis of the hip, the condition keeps getting worse until resting no longer relieves your pain. The hip joint gets stiff and inflamed. Bone spurs might build up at the edges of the joint.

When the cartilage wears away completely, bones rub directly against each other. This makes it very painful for you to move. You may lose the ability to rotate, flex or extend your hip. If you become less active to avoid the pain the muscles controlling your joint get weak, and you may start to limp.

Diagnosis

During a physical examination, your consultant will determine how much the disease has progressed and in doing so you will be required to move and rotate your leg and hip into various positions to check for pain.

An x-ray will be used to determine the extent of the osteoarthritis and also to detect if you have developed bone spurs or other abnormalities.

Non-surgical treatment

If you have early stages of osteoarthritis of the hip, known as gonarthrosis, treatment may include:

Surgical treatment

If you have later stages of osteoarthritis, your hip joint hurts when you rest at night, and/or your hip is severely deformed, your doctor may recommend total hip replacement surgery, known as an arthroplasty.

You will get a two-piece ball and socket replacement for your hip joint. This will cure your pain and improve your ability to walk. You may need crutches or a walking frame for a while after surgery.

Rehabilitation is important to restore the flexibility in the hip and work your muscles back into shape.

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