Hip Osteoarthritis

Hip osteoarthritis is a degenerative disease, meaning it gets worse over time. Symptoms may appear gradually, although it is also possible that you may get symptoms all at once. The most common symptom is hip pain and stiffness. You may feel these after sitting or resting for a while in the same position. Other symptoms include:

• Pain that gets worse with exercise or activity
• Stiffness in your hips
• Pain in the hip that may radiate to the knees
• Decreased range of motion in the hip
• Limping caused by hip pain or stiffness
• Increased joint pain when the weather changes
• “Locking” or “grinding” feeling in the hip joint

If you notice pain in your hip or other symptoms of osteoarthritis, talk to your healthcare provider for a diagnosis. If you have osteoarthritis of the hip, treating it quickly can help slow down its progression so you will be more comfortable for longer.

It’s common for the hip joint to experience wear and tear as you get older. Many people develop arthritis as they age. Osteoarthritis is a kind of arthritis that happens at the ends of the bones. It breaks down cartilage, causing swelling, pain, and deformity.

The causes of osteoarthritis of the hip are not all known. Factors that may contribute include:

• Joint injury. This may result from repeated movements or damage during sports.
• Joint overuse. For example, putting too much stress on the hip joint could be related to a job that requires heavy lifting, bending a lot, or standing for long periods.
• Increasing age. Wear and tear on joints builds up over the years.
• Being overweight. Extra weight puts added pressure on your hips and can break down cartilage faster.
• Genetic defects in the cartilage or joint.

Your healthcare provider will ask about your medical history, including your activity level. They will ask about your symptoms and do a physical examination to look for:

• Range of motion for your leg
• Pain or tenderness in the hip
• Problems with the way you walk
• A grating sound or sensation within the joint, called crepitus
• Any injury to the tendons, ligaments, and muscles around the hip

Your healthcare provider may also want to do imaging tests to better examine the hip joint. An x-ray can show if the joint space is normal or has narrowed due to osteoarthritis, if the bones have changed, or if there are any bone spurs. Some other tests your healthcare provider may recommend so they can see the tissues and bones of the hip are a CT scan, MRI, or a bone scan.

There is no cure for osteoarthritis of the hip, but there are many treatments.

Nonsurgical Treatments

• Medicines that help reduce inflammation may cut down on your arthritis pain. These include over-the-counter medicine, such as ibuprofen, naproxen, or acetaminophen, or corticosteroids or other prescription medicine.
• Physical therapy can help you increase your flexibility and range of motion and strengthen your leg muscles.
• Assistive walking devices, such as a cane or walker, can help you get around more easily.
• Modifying your activity can help slow down the progressions of hip osteoarthritis. Switching from high-impact activities, such as jogging or tennis, to low-impact activities, such as swimming, can put less stress on your hip joint.

Surgical Treatments

If you have serious hip damage that is causing a disability and are not able to find relief with medicine and physical therapy, you may be considering surgery.

• Hip replacement. In a traditional total hip replacement, the surgeon removes the entire head of the thigh bone as well as the damaged bone in the hip socket. These bones are then replaced with a new head and socket made of metal. A ceramic, metal, or plastic spacer is put between the head and the socket so they can glide smoothly against each other. Total hip replacement can be done on many kinds of patients of all ages. To access your hip joint, the surgeon may approach the area from the front (anterior) or side/back (posterior). The posterior approach is called a mini total hip replacement, because the incision is minimally invasive.
• Hip resurfacing. Hip resurfacing was developed as an alternative to total hip replacement. A surgeon reshapes the hip socket and top of the thigh bone and covers them with metal or plastic. Although it does not take out as much bone as a traditional hip replacement, it is not recommended for all patients. There are different types of resurfacing procedures, including partial and total.
• Osteotomy. This procedure is only rarely used. In an osteotomy, the head of the thigh bone or the hip socket is cut and realigned. This can take pressure off of the hip joint.

Besides these surgeries, there are other procedures and surgical hybrids. Because there are many options for hip surgeries with important differences in the procedures, you need to work with an experienced hip surgeon who can educate you on the pros and cons to each. Your healthcare provider will discuss options and recommend the treatment that fits your situation best.

You may not be able to completely prevent hip osteoarthritis, but there are some healthy habits you can start doing anytime to take the best care of yourself and possibly avoid future joint problems.

Exercising 5 times a week for 30 minutes helps your joints stay limber and strengthens the muscles that support the hips and knees. Exercise can also help keep your weight under control, which may help to keep some extra strain off your joints.

If you have diabetes, controlling your blood sugar can also reduce your risk of getting osteoarthritis. High glucose levels in your blood can make cartilage stiffer and more prone to wear out.

The hip joint fits together like a ball and socket. The top of the thigh bone (femoral head) is a smooth, rounded surface that fits into the hip socket. The bones are covered with smooth cushioning called cartilage. The cartlilage lets the bones glide against each other.

It’s common for the hip joint to experience wear and tear as you get older. Osteoarthritis [AH-stee-oh-ar-THRY-tis] is a common condition that many people develop in middle age or later. It’s a kind of arthritis that happens at the ends of the bones. It breaks down cartilage, causing swelling, pain, and deformity. Osteoarthritis can happen in any joint, but it often happens in weight-bearing joints, such as the hips.

In hip osteoarthritis, the cartilage of the hip gradually wears away, becoming rough and damaged. As cartilage disappears, the leg and hip bones rub directly on each other and become damaged. The damaged bones may even grow outward and cause bone spurs. All of this can cause pain, stiffness, decreased range of motion, and difficulty in daily tasks like bending over or walking.

Osteoarthritis is a degenerative [dee-JEN-uhr-it-iv] disease, meaning that it gets worse over time. Although there is no cure for osteoarthritis, if you seek help early, you can help to reduce its impact on your life. There are many treatments to help you stay active and manage pain of osteoarthritis.