Hip Osteoarthritis

Background

The hip is a ball-and-socket type of joint that is important for weight-bearing activity.  Pain-free function of the hip is required for most of the movements of our legs.  It is a joint that experiences quite a bit of stress throughout our lifetimes and can be prone to cartilage wear resulting in osteoarthritis.  When cartilage deteriorates leaving exposed bone inside of the hip joint inflammatory molecules are released into the joint fluid causing irritation of the bone and the surrounding tissues of the hip.  Often times the bone around the hip responds with extra bone growth called osteophytes or bone spurs, this can lead to further inflammation, pain, and decreased range-of-motion and pain.

Diagnosis

When someone has a history of pain in the hip it is important to evaluate the hip by physical exam as well as imaging studies (such as x-rays and in some cases MRI).  We take time to carefully and fully evaluate the hip looking for range-of-motion restrictions and likely sources of pain in the hip.  We use x-rays to evaluate the positioning, shape, and overall health of your hip joint.  While not directly visualized, x-rays can also give us insight into the overall health of the cartilage in your hip.  If the space between the bones in your hip is getting narrow, it can indicate that you have cartilage wear and that you are developing osteoarthritis.  Bone spurs may also be present on the the ball or the socket side of your hip as further evidence that you are developing osteoarthritis.

Treatment

In the early arthritic hip, treatment may initially consist of activity modification (ie. don’t do things that irritate the hip), anti-inflammatory treatment with over the counter medications such as acetaminophen, ibuprofen, or naproxen, or a combination of both.  As osteoarthritis worsens, injection of a more potent antiinflammatory such as a corticosteroid directly into the hip may be indicated.  This allows the antiinflammatory medication to be focused into the the hip joint  and can provide very good and long lasting pain relief.  

When conservative measures are no longer providing adequate pain relief, the surgical option of total hip replacement may be explored.  We offer both anterior and posterior approaches to total hip replacement.

Regardless of which treatment option is pursued, we want you to have a hip with full range-of-motion and good neuromuscular control.  Occasionally you may be asked to go to physical therapy  prior to any surgical intervention.  Therapy prior to surgery can help address strength and mobility issues that may prevent you from achieving your goals for full activity after surgery. In addition you can become comfortable with the types of exercises you will be required to perform in order to fully rehabilitate your shoulder after surgery.

Rehabilitation

As with many orthopedic surgeries, rehabilitation is necessary for you to achieve full function of your hip after surgery.  This is especially true of posterior approaches to total hip replacement.  We encourage you to be an active participant in your rehabilitation process and work to regain your normal range of motion,  gait, and strength after surgery.