The hip joint is a ball-and-socket joint, formed by the articulation between the top of the thigh bone (femoral head) and the pelvis (acetabulum). The articular surfaces of the hip joint are lined with hyaline cartilage. This cartilage is smooth and allows for frictionless, painless movement of the hip joint. Degeneration of this cartilage results in osteoarthritis of the hip joint, a very common problem characterised by pain and stiffness in the joint.
Hip osteoarthritis: Symptoms
The most common symptom of osteoarthritis of the hip is pain. The exact nature of pain will vary from person to person. Initially, pain may only be felt when doing more strenuous exercise or after prolonged periods on your feet. As it gets more severe, the pain may be present for most of the day and trouble you when sleeping. Classically the pain is felt in the groin, although some patients present with thigh and knee pain or buttock pain.
Hip osteoarthritis: Causes
The exact cause of osteoarthritis is not always known. It is usually a slow, progressive problem that involves wear and tear of the joint, and is more common in older patients. Most often, several factors play a role in someone developing osteoarthritis of the hip. Although there is no specific gene identified to cause arthritis, we know it can run in families. Patients who have poor hip development as a child or infant can be predisposed to arthritis at an earlier age. Importantly, many patients develop osteoarthritis after previous trauma.
Hip osteoarthritis: Diagnosis
Often, the diagnosis can be made during a medical consultation and examination, which is confirmed with X-rays of your hip. Sometimes you might be offered an MRI scan, which can help determine whether damage to other areas of the hip is impacting your pain.
Hip osteoarthritis: Treatment
Unfortunately, the damage to the cartilage and tissues within the hip is irreversible, so there is no ‘cure’ for osteoarthritis. Because of this, the treatment of osteoarthritis generally revolves around managing your symptoms in the initial stages, and progressing to more definitive treatments when your symptoms dictate it.
The most common starting point for non-operative treatment for osteoarthritis of the hip includes simple painkillers (paracetamol or Panadol osteo) and anti-inflammatories if tolerated (and not contraindicated). Activity modification can help relieve the amount of time you are on your feet. Commencing low-impact exercise (swimming and cycling, pilates, gym, yoga etc) can reduce the stress on the arthritic joint and therefore improve your symptoms.
Injections to the hip may help to reduce pain and I may recommend these for you. It is important to maintain a healthy body weight by keeping to a balanced diet and undertaking regular low-impact exercise.
In more advanced cases, I may recommend you consider surgical intervention for treatment of your hip osteoarthritis. This procedure is known as total hip replacement.
Total hip replacement – During the surgery, an approach is made to the hip joint, the damaged ball and socket are removed and new components are inserted. The stem, ball and socket are made of metal, with a plastic (polyethylene) liner placed between the ball and socket to allow for safe, frictionless movement. Depending on the quality of the bone and the age of the patient either a cemented or cementless component will be used. The incision is then closed using stitches and dressings are put on. Generally, this procedure takes approximately an hour of surgical time.
If you are experiencing hip pain, please make an appointment to discuss your treatment options.