Hip arthritis

Osteoarthritis (OA) is the most common type of hip arthritis.

OA is also known as wear-and-tear arthritis or degenerative joint disease. It is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage is worn away by hip arthritis, bare bone is exposed within the joint.

Other types of arthritis including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, and pseudogout may all affect the hip.

Hip arthritis typically affects patients past the age of 40 years, although it may occur earlier in people who are predisposed as a result of genetics or previous trauma. It is more common in patients who are overweight, and weight loss tends to reduce the symptoms associated with hip arthritis.

There is also a genetic predisposition of this condition, meaning hip arthritis tends to run in families. Other factors that can contribute to developing hip arthritis include trauma to the hip and fractures to the bone around the joint.

Hip arthritis symptoms tend to progress as the condition worsens.

Hip arthritis symptoms do not always progress steadily with time. Often patients report good months and bad months or symptom changes with weather changes.

The most common symptoms of hip arthritis are:

•Pain with activities
•Limited range of motion
•Stiffness of the hip
•Walking with a limp
•Limited ability to get shoes and sox on and off the affected foot
•Limited ability to go up stairs

Evaluation of a patient with hip arthritis should begin with a physical examination and x-rays. These can serve as a baseline to evaluate later examinations and determine progression of the condition.

Treatment of hip arthritis should begin with the most basic steps. Not all treatments are appropriate in every patient and surgery is reserved for the last step.

•Weight loss is probably one of the most important, yet least commonly performed treatments. The less weight the joint has to carry, the less painful activities will be.
•Limiting certain activities may be necessary, and learning new exercise methods may be helpful. Instead of high impact running, aquatic exercise is an excellent option.
•Stretching exercises are often very helpful in alleviating pain.
•Use of a cane or a single crutch is the hand opposite the affected hip will help decrease the demand placed on the arthritic joint.
•Strengthening of the muscles around the hip joint may help decrease the burden on the hip. Preventing atrophy of the muscles is an important part of maintaining functional use of the hip.
•Anti-inflammatory pain medications (NSAIDs) and analgesics are helpful for reducing pain and inflammation.
•Good quality forms of glucosamine and chondroitin supplements are safe and effective for treatment of osteoarthritis.
•Total hip replacement surgery is a procedure where the cartilage is removed and a metal and plastic implant is placed in the hip.

Before considering hip surgery, patients should look into a newer treatment called guided mesenchymal layering. This is a stem cell based therapy. This procedure uses autologous stem cells (stem cells harvested from the patient). A small gauge needle is used to irritate the area of damage which often includes bare bone under ultrasound and arthroscopic guidance. The patient's stem cells and platelet rich plasma (which contains many growth factors) are injected into the joint. For OA of the hip, this may be the treatment of choice!

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