Hip Arthritis
What is Arthritis?
Arthritis is inflammation in a joint, and it can cause pain or stiffness. Arthritis is a leading cause of hip pain, and is a progressive condition, which means that it gets worse over time. While arthritis can’t be cured, there are many treatments available that can help reduce pain and preserve a patient’s range of motion.
Types of Hip Arthritis
There are many forms of arthritis that may impact the hip joint.
Osteoarthritis
Osteoarthritis is a common effect of aging and is caused by wear and tear on a joint. While osteoarthritis can affect any joint, this degenerative form of arthritis is most commonly seen in weight-bearing joints like the hip.
The ball and socket of the hip joint are covered with cartilage, which helps to cushion the bones and makes it easy for them to move fluidly. Over time, this cartilage can gradually wear away, becoming rough, can no longer cushion the bones of the hip as they move against each other. In some patients, bones of the hip may develop bone spurs as a reaction to osteoarthritis
While the most common cause of hip osteoarthritis is the natural aging process, individuals who have had a previous hip injury, who have a family history of osteoarthritis, who are obese, or have a malformation of the hip joint may be at a higher risk of developing this condition.
Osteoarthritis has no cure, but symptoms can be greatly reduced through lifestyle modifications, physical therapy, and medications. In some cases, patients with severe hip osteoarthritis may benefit from a total hip replacement, hip resurfacing, or osteotomy.1
Rheumatoid Arthritis
Rheumatoid arthritis is an inflammatory form of arthritis. This is a chronic condition that mostly affects the joints, and is a result of an immune system that begins to attack the body.
In people with rheumatoid arthritis, the lining of the joint swells to the extent that it begins to invade nearby tissues. This process leads to the production of chemical substances that attack the surface of the joint. Over time, the ligaments and cartilage surrounding a joint begin to change as a result of rheumatoid arthritis, and this can lead to painful contractures and deformities.
Rheumatoid arthritis is not genetic and is usually triggered by an environmental factor or an infection that causes an inappropriate immune response. Rheumatoid arthritis can sometimes be controlled with medications that help alleviate symptoms and prevent the immune system from attacking healthy tissues. Pain medication, exercise, and physical therapy are also helpful. In some cases, hip replacement surgery is the best way to restore hip function impacted by rheumatoid arthritis.2
Ankylosing Spondylitis
Ankylosing spondylitis is another form of inflammatory arthritis that most commonly affects the spine and sacroiliac joint, but that can also cause inflammation of the hip joint. This form of arthritis is more common in men than in women, and typically starts to impact people between the ages of 17 and 35.
Individuals with ankylosing spondylitis often experience periods of remission where they experience mild symptoms or no symptoms at all, followed by flares when the condition is worse.
Systemic Lupus Erythematosus
Systemic lupus erythematosus, commonly known as lupus, is an autoimmune disorder that can affect the nervous system, joints, and skin. Lupus can cause inflammation, muscle pain and aches, and arthritic pain, stiffness, or warmth in the joints.When lupus affects the hip, joint pain is often the first symptom.3
Psoriatic Arthritis
Psoriatic arthritis is linked to the skin disease psoriasis. Though psoriatic arthritis more commonly affects smaller joints, it is possible that it can cause stiffness, pain, and swelling in the hip.
Hip Arthritis Symptoms
Symptoms of hip arthritis may include:
- Hip joint pain that may extend to the buttocks, outer thigh, groin, or knee
- Hip arthritis pain is often worse in the morning or in humid weather, and eases with activity
- Pain that increases with extended or vigorous activity
- Grinding noise when the hip joint moves
- Locking or sticking of the hip joint
- Difficulty walking
- Limping
- Limited range of motion
- Stiffness
- A sensation of warmth around the hip joint
Diagnosis of Hip Arthritis
Hip arthritis can usually be diagnosed by a thorough physical examination performed by your doctor. During this exam, your doctor will take account of your range of motion, where you are experiencing pain, and the strength of your hip. He or she may ask for additional diagnostic tests, such as a CT scan to check the bones and joint of your hip or an MRI to look at the soft tissues like tendons, muscles, and ligaments.
Treatment for Hip Arthritis
There is no cure for arthritis, but it is possible to alleviate symptoms and help prevent joint destruction with effective treatment.
Non-Surgical Hip Arthritis Treatment
When it comes to non-surgical treatment for hip arthritis, most patients find that a combination of therapies is most effective. Non-surgical hip arthritis treatments may include:
- Anti-inflammatory Drugs: Medications like ibuprofen and naproxen (NSAIDs or non-steroidal anti-inflammatory drugs) can help reduce pain and alleviate inflammation from arthritis.
- Corticosteroids: Corticosteroids, like prednisone, are key to reducing inflammation from arthritis. These medications may come in the form of pills, injections, or topical creams.
- Immune dDugs: Disease-modifying antirheumatic drugs (DMARDs) can slow damaging immune system responses in patients with conditions like rheumatoid arthritis. Common DMARDs include Methotrexate and sulfasalazine.
- Injection Therapy: Many of our hip arthritis patients benefit from treatments like platelet injections (platelet injections) treatments, Mesenchymal Stromal Cell (MSC) treatments, or other forms of orthobiologics.
- Physical Therapy: A physical therapist can recommend specific exercises that may help preserve or increase range of motion and strengthen the muscles around the hip joint.
In general, moderate, regular exercise helps to decrease stiffness associated with arthritis.
Surgery for Hip Arthritis
When our patients do not find adequate relief from non-surgical hip arthritis treatments, it may be time to consider surgical treatment. Surgical treatment for hip arthritis may include:
- Total Hip Replacement: During this procedure, damaged cartilage and bone are removed and the hip joint is replaced with a metal or plastic artificial joint. This treatment is most frequently recommended for patients with rheumatoid arthritis or ankylosing spondylitis that affects the hips.
- Hip Resurfacing: Hip resurfacing is a hip replacement procedure where damaged bone and cartilage are removed from the hip socket (acetabulum) and replaced with a metal shell. The head of the femur is fitted with a smooth metal cap.
- Osteotomy: An osteotomy involves the cutting and realignment of the head of the thigh bone or the hip socket. This alleviates pressure on the hip joint and is sometimes the recommended treatment for hip osteoarthritis.
- Synovectomy: The synovium is the thin lining that covers the surface of the hip joint. Surign a synovectomy, part or all of the synovium is removed. This treatment may be suitable for patients in early stages of inflammatory hip arthritis.4
Contact Beacon Orthopaedic
If you are suffering from pain or decreased mobility in your hip joint, the cause could be arthritis. The experienced hip specialists at Beacon Orthopaedics can properly diagnose your condition and recommend the most appropriate treatment to reduce your symptoms and keep you moving. For more information on hip arthritis treatment, please contact us to schedule a consultation.
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1 The American Academy of Orthopaedic Surgeons. Hip osteoarthritis. Available: https://orthoinfo.aaos.org/en/diseases–conditions/osteoarthritis-of-the-hip/. Accessed April 29, 2021.
2 The American Academy of Orthopaedic Surgeons. Rheumatoid arthritis. Available: https://orthoinfo.aaos.org/en/diseases–conditions/rheumatoid-arthritis/. Accessed April 29, 2021.
3 The American Academy of Orthopaedic Surgeons. Inflammatory arthritis of the hip. Available: https://orthoinfo.aaos.org/en/diseases–conditions/inflammatory-arthritis-of-the-hip/. Accessed April 29, 2021.
4 The American Academy of Orthopaedic Surgeons. Inflammatory arthritis of the hip. Available: https://orthoinfo.aaos.org/en/diseases–conditions/inflammatory-arthritis-of-the-hip/. Accessed April 29, 2021.