Arthritis of the Hip
Arthritis of the hip is a condition in which there is loss of the cartilage of the head of the thighbone and of the cup-shaped socket of the pelvis where the thighbone fits into the joint (the acetabulum). This cartilage allows the bone to glide inside the socket of the joint as you move. When the cartilage is damaged or lost, bone rubs against bone causing pain, tenderness and swelling (inflammation) and limitation of your ability to move freely.
Because of the damage to the cartilage, people with arthritis may feel as though their hip is stiff and their motion is limited. Sometimes people feel a catching or clicking within the hip. The pain usually gets worse when the hip joint is strained by walking long distances, standing for a long time or climbing stairs. The pain is usually felt in the groin, but also may be felt on the side of the hip, the buttock and sometimes into the knee.Causes and Risk Factors
Arthritis of the hip usually occurs in people as they enter their 60's and 70's. This varies depending on your weight, activity level and the structure of your unique hip joint. Arthritis may be caused by many factors, including simple wear and tear, inflammatory disorders such as lupus or rheumatoid arthritis, infections or injury.
Loss of cartilage can be seen on X-ray as a loss of the space between the two ends of bone.
Depending on the severity of arthritis and your age, hip arthritis may be managed in a number of different ways including any or a combination of the following:
- Conservative care
- Pain management
- Losing weight to reduce the forces on your hip joint
- Changing your activities to avoid strain on your hip
- Using assistive devices such as a cane in your opposite hand
- Hip replacement
An osteotomy is a good option if you are young and the arthritis is limited to a small area of the hip joint. It allows the surgeon to rotate the arthritic bone away from the hip joint, so the weight is carried on the healthier parts of the hip joint. The advantage of this surgery is that the patient's own hip joint is kept, and can potentially give many years of pain relief without the disadvantages of an artificial hip. The disadvantages are that it takes long for rehabilitation and that arthritis may develop in the newly aligned hip.
Hip replacement surgery involves cutting away the arthritic bone and replacing it with an artificial joint. Both the ball (at the top of the thighbone) and the socket (at the bottom side of the pelvic bone) are replaced, usually with a metal ball and a plastic socket. The ball is placed on a stem placed inside the femur (thigh bone), with or without cement. The socket is inserted within the natural joint socket of the pelvis (the acetabulum) after the arthritic surface is removed.