Osteoarthritis hip progression treatment
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Osteoarthritis (OA) of the hip is one of the most common problems that presents to a rheumatologist. Early hip OA causes pain in the groin and in the buttock. Some pain may radiate down the thigh.
X-rays show loss of joint space with spur formation. These spurs are referred to as osteophytes. Osteophytes are composed of bone and cartilage and are an attempt by the joint to repair itself.
With progression, OA advances so that there is complete loss of joint space and changes in the bone of the head of the femur (lower leg bone) as well as the acetabulum, the socket of the pelvis.
By this time the patient notices restricted range of motion, with difficulty going up and down stairs, getting their shoes on and off, and stiffness with sitting. Pain becomes more constant especially at night. A limp is noticeable.
Cysts form inside the bone and the surrounding joint capsule become more inflamed. Ligaments surrounding the joint become loose.
At the last stage of disease, there is collapse of the head of the femur and deformity of the acetabulum. The labrum, or lip of the acetabulum, may become torn secondary to the arthritis.
There is complete loss of range of motion. Pain has become intolerable. There is a pronounced difference in leg length.
Early treatment of hip OA involves stretching, weight reduction, analgesic medications, and non-steroidal anti-inflammatory drugs. Injections of glucocorticoids (steroids) may help relieve pain. They also have the downside of causing further degradation of cartilage. It is at this stage that autologous mesenchymal stem cells may be of most value. Once there is deformity of the femoral head or acetabulum, stem cells are unlikely to be of benefit.
With further progression, joint surgery, either resurfacing for younger patients, or total joint replacement surgery for more advanced disease is required.
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