Hip arthritis is a common cause of hip pain. Affecting more and more people daily, hip arthritis is one of the leading causes of disability in North America.
Hip arthritis occurs when the cartilage covering the bones of the hip joint breaks down. The cartilage of the joints is a very smooth material. This cartilage lowers the friction during joint motion, leading for smooth movement of the bones during activity.
Cartilage breakdown can occur because of mechanical problems of the hip and/or an inherent issue with the cartilage itself. There can be mild arthritis where a small area of cartilage is affected, or severe arthritis where the majority of the cartilage is damaged and the bones have no cushion between them leading to the so called “bone on bone“ situation.
Osteoarthritis is a form of arthritis in which mechanical issues lead to the eventual breakdown of the articular cartilage. These mechanical issues include hip dysplasia, hip impingement, as well as hip trauma.
In other forms of arthritis, inflammation is actually the reason the cartilage breaks down in the first place. Rheumatoid arthritis is the most commonly known, but there are many. Recent advancements in the medical treatment of inflammatory arthritis has decreased the role of surgery in the treatment of these conditions.
Symptoms of Hip Arthritis
A classic symptom of hip arthritis is joint pain. This may be a dull, aching pain in the groin, outer thigh, or buttocks. The pain is often worse in the morning, but after you get up and move around for awhile, it may lessen. Vigorous activity can also aggravate the pain and increase stiffness. Movement may be limited because of the pain as well as stiffness. Eventually even walking may become difficult.
Typically the extremes of motion are the most painful. With time all movement is painful. There can also be episodes where the joint feels as if it will give way due to the sudden onset of sharp pain. The joint may also become locked and difficult to change position as the condition advances.
There are a number of non surgical treatments for hip arthritis. These treatments are directed at controlling the inflammation caused by arthritis and minimizing the weakness and stiffness that is often present. Anti inflammatory medication is usually recommended. Cortisone injections in the joint can also give temporary relief. As with any medication, one needs to be aware of the risks. Physical therapy and exercise are also important to reduce stiffness and weakness.
When these non surgical treatment fail to provide adequate pain relief, joint replacement may be recommended. The type of surgery recommended depends on several factors including age, presence of obesity, the condition of the hip joint and surrounding bone, and the underlying cause of the arthritis.
Some recent advances in hip replacement enable placement of implants through a less invasive approach, as well as continued improvement in the longevity of these implants. We are also looking at novel implants for hip replacement, including hip resurfacing.