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Hip Osteoarthritis

What is hip osteoarthritis?

Hip osteoarthritis describes a process of degenerative change within the hip joint. It is a common condition that affects the cartilage, that cushions and protects the ends of bones in the hip joint. Over time, the cartilage in the hip joint can undergo degenerative change, resulting in wear and thinning, leading to pain, stiffness, inflammation and loss of function in the hip.

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Who is affected by hip osteoarthritis?

 

Hip osteoarthritis is most common in adults over the age of 50, with risk increasing with age. Women are more likely than men to develop hip osteoarthritis, especially after menopause. Other factors that increase the risk of hip osteoarthritis include:

Obesity

Excess weight puts extra stress on the hip joint.

Previous hip injuries

Injuries to the hip, such as fractures or dislocations, can increase the risk of developing osteoarthritis later in life.

Family history

Having a family history of osteoarthritis increases your risk of developing it yourself.

Certain occupations

Jobs that require repetitive hip movements or heavy lifting can increase the risk of developing hip osteoarthritis.

What are the main symptoms of hip osteoarthritis?

 

The main symptoms of hip osteoarthritis include:

  • Pain:

    Pain in the hip or groin, especially when walking, climbing stairs, or getting into and out of chairs. Patients may also describe discomfort when bending forwards to put on socks and shoes or when getting into or out of a car.

  • Stiffness:

    Stiffness in the hip, especially in the morning or after periods of inactivity, i.e. when going from sitting to standing.

  • Loss of range of motion:

    Difficulty moving the hip in a full range of motion, i.e. sitting in a cross-legged position.

  • Creaking or popping sounds:

    Crepitus, or grating or clicking sounds, when moving the hip.

  • Grinding sensation:

    A feeling of grinding or rubbing when moving the hip.

Symptoms may worsen gradually over time and may fluctuate depending on the level of activity. Activities that involve weight-bearing, such as walking, climbing stairs, or standing for long periods, tend to aggravate the pain and discomfort.

How is hip osteoarthritis diagnosed?

Diagnosis of hip osteoarthritis typically involves a physical examination, medical history review, and imaging tests.

  • Physical examination:

    The doctor will carefully examine the hip, checking for pain, tenderness, range of motion limitations, and crepitus. Specific tests may be performed to assess the severity of the osteoarthritis and rule out other causes of hip pain. Pain tends to be worse when the hip is bent, bringing the knee towards the chest with catching discomfort or with internal rotation (where the hip is rotated inwards).

  • Medical history:

    The doctor will inquire about the patient's symptoms, activities, any previous hip injuries, and family history of osteoarthritis.

  • Imaging tests:

    X-rays are often used to visualize the bones in the hip joint, looking specifically for narrowing of the joint space, osteophytes (bone spurs), or other signs of osteoarthritis. In some cases, an ultrasound or MRI scan may be recommended to provide more detailed images of the soft tissues, including the cartilage, in the hip joint.

How is hip osteoarthritis treated?

 

Treatment for hip osteoarthritis focuses on managing symptoms, slowing the progression of the condition, and improving function. Non-surgical treatments are usually tried first, and surgery is considered if non-surgical measures fail to provide adequate relief.

Non-surgical treatments:

  • Weight management:

    Losing weight can help reduce stress on the hip joint and alleviate pain.

  • Exercise:

    Low-impact exercises, such as walking, swimming, or water aerobics, can help improve range of motion, strengthen the muscles around the hip, and reduce pain, without overloading the joint..

  • Over-the-counter pain relievers:

    Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help alleviate mild to moderate pain and inflammation.

  • Physiotherapy:

    Physiotherapy can provide exercises and stretches to improve range of motion, strengthen the muscles around the hip, and promote normal hip movement patterns.

  • Assistive devices:

    Using assistive devices, such as a stick or frame, can help reduce stress on the hip joint and alleviate pain.

Corticosteroid injections can be an effective way of reducing inflammation and pain in the hip joint. At The Joint Injection Clinic, corticosteroid injections are performed after a thorough consent process, whereby the risk and benefits of the procedure are discussed in detail with your doctor. The experienced medical doctor will then place you in a lying position with the front of the hip facing upwards. The skin is cleaned using a cleaning solution to ensure that the procedure is performed under sterile conditions. Local anaesthetic is injected from the skin to the joint under ultrasound guidance. After giving the local anaesthetic a few minutes to take effect, the hip joint injection is performed with a small dose of steroid and local anaesthetic, targeting the front part of the ball and socket joint.

The injection itself is normally completed within 30-60 seconds, after which a plaster is applied and post-injection advice is given. The patient is advised to look out for any signs of infection, specifically to check whether the local area becomes red, hot, tender, swollen or if they develop a fever. If this occurs then the patient is asked to contact the clinic immediately at which time a formal reassessment will occur and if needed oral antibiotics can be prescribed. The patient is also warned that following any injection they may notice a short-term worsening or flare in their symptoms after the local anaesthetic has worn off (4-5 hours). This may last for 3-5 days and the patient is advised to consider icing of the area using an ice pack for 10-15 minutes every hour as required.

Surgical treatments:

If non-surgical treatments fail to provide adequate relief, surgery may be considered. Surgical options for hip osteoarthritis include:

  • Hip replacement:

    This procedure involves replacing the damaged hip joint with an artificial joint made of metal, plastic, or ceramic.

Surgery is typically considered for patients with severe hip osteoarthritis that causes severe pain or significantly impacts their quality of life and limits their ability to perform daily activities.

Additional tips for managing hip osteoarthritis pain:

  • Avoid activities that aggravate the pain, such as high-impact exercises or running.
  • Pace yourself and take breaks when necessary.
  • Wear supportive shoes with good cushioning.
  • Use assistive devices if needed.
  • Maintain a healthy weight to reduce stress on the hip joint.