Osteoarthritis (OA) is the most common type of arthritis, with over 28 million Americans affected. OA is also referred to as degenerative arthritis or degenerative joint disease.
In a healthy hip joint, cartilage covering the end of the bones in the joint allows the joint to move freely by creating a smooth surface and acting as a cushion between the bones. In hip osteoarthritis, the cartilage wears down resulting in a rough surface and interfering with the movement of the joint, which can cause pain. As the condition worsens, the bones in the hip can also wear down and cause bone spurs. Eventually, pieces of bone and cartilage may chip away and float within the joint. In advanced osteoarthritis of the hip, the cartilage wears away, causing bone to rub against bone and cause even further damage to the joint.
Hip arthritis symptoms begin as very mild and gradually worsen over time. Symptoms may include:
- Hip pain
- Pain in the groin or thigh that may radiate to the knees or buttocks
- Decreased range of motion in the hip
- Crepitus, which is a grinding sound heard in the joint during movement
- “Locking” of the joint
Those with osteoarthritis—hip or otherwise—report pain and stiffness that is worse on waking or after sitting or resting. Rainy weather and vigorous activity can also cause joint pain to flare up.
Hip osteoarthritis is caused by the deterioration of the cartilage that cushions the ends of the bones in your hip joint. Though there is not a specific known cause for this, there are factors that may increase your chances of developing the condition.
Certain risk factors are known to increase a person’s risk for osteoarthritis of the hip. These include:
Though anyone can develop osteoarthritis, it most commonly affects people over the age of 65.
The risk is higher for those with a family history of the condition.
- Being overweight.
Excess weight places extra strain on the joints, increasing the risk of degenerative arthritis. Hip and knee joints are joints most affected by excess weight.
- Previous hip injury.
Those who have a previous injury to the hip joint are more susceptible.
- Hip dysplasia and other joint abnormalities.
Being born with structural abnormalities in the hip joint increases the likelihood of hip osteoarthritis.
- Certain occupations and activities.
Activities that entail repetitive stress on the hip joint can lead to hip osteoarthritis.
In order to diagnose hip osteoarthritis, your doctor will begin by asking you questions about your medical history and symptoms. You will be asked to:
- Describe your symptoms
- Provide details about when the symptoms began and how they impact your daily activities
- Provide information about any family history of osteoarthritis of the hip
A physical examination is also an important part of diagnosing degenerative arthritis. Hip pain will be evaluated, along with strength and flexibility. The doctor will also look for areas that are swollen and tender.
Diagnostic tests play an important role in diagnosing osteoarthritis. These can include:
These can show degenerative changes, bone spurs, and other signs of osteoarthritis.
- Magnetic resonance imaging (MRI).
This type of scan provides highly detailed images of the cartilage, bones, and soft tissues, enabling doctors to diagnose OA even in its early stages.
- Joint aspiration.
A needle is used to remove a sample of joint fluid that will be checked for crystals and other indicators of joint deterioration, inflammation, and other types of arthritis.
Even though there is no cure for osteoarthritis, there are many options for treating hip osteoarthritis symptoms. The goal of treatment is to relieve your pain and help you improve mobility. This can be done using a combination of treatment options, starting with the least invasive.
Hip arthritis treatment options include:
- Activity modification.
You may be able to relieve your symptoms and slow progression of OA by minimizing activities that aggravate your hip joint and opting for low-impact activities.
- Weight loss.
Losing weight reduces the harmful load that excess weight places on your hip and other joints.
Over the counter pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce inflammation. Your doctor may prescribe stronger medications if needed. Corticosteroids (oral or injectable) may also be prescribed if needed.
- Physical therapy.
A physical therapist can provide you with exercises to increase your strength and flexibility and increase range of motion in your hip. This can improve pain and stiffness and reduce the risk of injury.
- Occupational therapy.
By working with an occupational therapist you can learn ways to go about your daily tasks at work and home without putting extra stress on your hip.
According to the Arthritis Foundation, gentle exercise, such as yoga and tai chi, may help manage pain and stiffness.
- Assistive devices.
Canes, walkers and other assistive devices can improve mobility and help you function independently.
If hip osteoarthritis significantly impacts your daily life or if your symptoms have failed to improve despite using other treatments for some time, your doctor may recommend surgery. There are a few different procedures available for osteoarthritis of the hip, including:
- Hip resurfacing.
This procedure entails removing the damaged bone and cartilage from the hip socket and resurfacing the head of the femur with a smooth metal cap.
- Total hip replacement.
This procedure entails removing and replacing the hip joint’s socket (acetabulum) and femoral head (head of the thighbone) with prosthetics to restore your hip’s function.
This procedure is not used often for hip osteoarthritis and is often only considered for younger patients to delay hip replacement surgery. It entails realigning the hip joint by trimming the femoral head or socket to relieve pressure on the joint and slow progression.
- Minimally invasive arthroscopy.
At ARO, we strive to get you back to your active life with the least invasive procedures possible. When combined with regenerative medicine and denervation, arthroscopy could be the best option to relieve your joint pain.
Treatment will be based on different factors like age, weight and symptoms.