hip arthritis
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M.S. ORTH (Pune),M.Sc., ORTH. (London) Dipl. LAMP (CARDIFF)
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Hip Arthritis

 

  WHAT IS HIP ARTHRITIS?
 
Introduction
 


Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative , or wear-and-tear, arthritis. OA commonly affects the hip joint. In the past, little was done for the condition. Now doctors have many ways to treat hip OA so patients have less pain, better movement, and improved quality of life.

   
 

This guide will help you understand

 
»

how OA develops in the hip

»

how doctors diagnose the condition

»

what can be done for your pain

   
  Anatomy
 

Which part of the hip does OA affect?

 

Articular cartilage is the smooth lining that covers the surfaces of the ball-and-socket joint of the hip. The cartilage gives the joint freedom of movement by decreasing friction. The layer of bone just below the articular cartilage is called subchondral bone . The main problem in OA is degeneration of the articular cartilage.

When the articular cartilage degenerates , or wears away, the subchondral bone is uncovered and rubs against bone. Small outgrowths called bone spurs or osteophytes may form in the joint.
 
 
  Causes
  How does OA develop?
 


OA of the hip can be caused by a hip injury earlier in life. Changes in the movement and alignment of the hip eventually lead to wear and tear on the joint surfaces. The alignment of the hip can be altered from a fracture in the bones around or inside the hip. If the fracture changes the alignment of the hip, this can lead to excessive wear and tear, just like the out-of-balance tire that wears out too soon on your car. Cartilage injuries, infection, or bleeding within the joint can also damage the joint surface of the hip.

Not all cases of OA are related to alignment problems or a prior injury, however. Scientists believe genetics makes some people prone to developing OA in the hip.

Scientists also believe that problems in the subchondral bone may trigger changes in the articular cartilage. As mentioned, the subchondral bone is the layer of bone just beneath the articular cartilage. Normally, the articular cartilage protects the subchondral bone. But some medical conditions can make the subchondral bone too hard or too soft, changing how the cartilage normally cushions and absorbs shock in the joint.

Avascular necrosis (AVN) is another cause of degeneration of the hip joint. In this condition, the femoral head (the ball portion of the hip) loses a portion of its blood supply and actually dies. This leads to collapse of the femoral head and degeneration of the joint. AVN has been linked to alcoholism, fractures and dislocations of the hip, and long-term cortisone treatment for other diseases.

   
  Symptoms
 

What does OA of the hip joint feel like?

 


The symptoms of hip OA usually begin as pain while putting weight on the affected hip. You may limp, which is the body's way of reducing the amount of force that the hip has to deal with. The changes that happen with OA cause the affected hip to feel stiff and tight due to a loss in its range of motion. Bone spurs will usually develop, which can also limit how far the hip can move. Finally, as the condition becomes worse, pain may be present all the time and may even keep you awake at night.

   
  Diagnosis
 

How do doctors identify the problem?

 


The diagnosis of hip OA starts with a complete history and physical examination by your doctor. X-rays will be required to determine the extent of the cartilage damage and suggest a possible cause for it.

Other tests may be required if there is reason to believe that other conditions are contributing to the degenerative process. Magnetic resonance imaging (MRI) may be necessary to determine whether your hip condition is from problems with AVN.

  Blood tests may be required to rule out systemic arthritis or infection in the hip.
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