Cartilage is a slippery, rubbery material that covers the ends of bones in normal joints. The primary function of cartilage is to reduce friction in the joint and serve as a "shock absorber." Osteoarthritis occurs when this protective cartilage wears down over time. As the cartilage wears away, it becomes frayed and rough, and the protective layer between the bones decreases. This can result in bone rubbing on bone. To make up for the lost cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes).
There are two main types of osteoarthritis:
Primary: More generalized osteoarthritis that affects the fingers, thumbs, spine, hips, and knees
Secondary: Osteoarthritis that occurs after injury or inflammation in a joint, or as a result of another condition that may affect the composition of the cartilage, such as rheumatoid disease, gout…
The most common symptom of hip osteoarthritis is pain around the hip joint. The pain usually develops slowly and worsens over time. Pain and stiffness may be worse in the morning, or after sitting for a while and flares up with vigorous activity. Over time, painful symptoms may occur more frequently, including during rest or at night.
Stiffness in the hip joint that makes it difficult to walk or bend e.g. while putting on your socks
Clinical examination and X-rays are usually enough to reach the diagnosis. The x-rays will show the amount of narrowing of the joint space indicating cartilage wear and formation of bony spurs.
There is no definitive cure for osteoarthritis, but there are a number of treatment options that will help relieve pain and improve mobility.
This is indicated mainly in early mild cases and includes:
- Lifestyle modifications including:
- Losing weight reduces stresses on the hip joint, resulting in less pain and better function.
- Minimizing activities that aggravate the condition, such as prolonged standing and climbing stairs.
- Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) to put less stress on the joint.
- Physiotherapy. Some exercises can help increase the range of motion and flexibility, and to strengthen the muscles in the hip.
- Assistive devices. Using walking supports like a cane, crutches, or a walker take weight off the affected hip and can improve mobility and independence. It also decreases the stresses on the hip joint.
- Medications. If your pain affects your daily routine, or is not relieved by other nonsurgical methods, your doctor may add medication to your treatment plan.
- Paracetamol is an over-the-counter pain reliever that can reduce mild arthritis pain. Like all medications, however, over-the-counter pain relievers can cause side effects and interact with other medications you are taking. Be sure to discuss potential side effects with your doctor.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may relieve pain and reduce inflammation. Over-the-counter NSAIDs include naproxen and ibuprofen.
It is indicated in severe cases in which pain is not relieved by nonsurgical treatment.
Total hip replacement. Your doctor will remove both the damaged acetabulum and femoral head, and then position new metal, plastic or ceramic joint surfaces to restore the function of your hip. This video courtesy of AAOS explains the procedure.