What You Need to Know About Hip Osteoarthritis

Hip osteoarthritis is a common type of osteoarthritis (OA). Since the hip is a weight bearing joint, osteoarthritis can cause significant problems. About 1 in 4 Americans can expect to develop osteoarthritis of the hip during their lifetime, according to research presented at the 2006 American College of Rheumatology annual meeting.

Early diagnosis and treatment help manage hip osteoarthritis symptoms.

An overview of hip osteoarthritis will help you understand symptoms, diagnosis, and treatment options.

Causes of Hip Osteoarthritis

Hip osteoarthritis is caused by deterioration of articular cartilage and wear-and-tear of the hip joint. There are several reasons this can develop:

• previous hip injury
• previous fracture, which changes hip alignment
• genetics
• congenital and developmental hip disease
• subchondral bone that is too soft or too hard
• avascular necrosis

Diagnosis of Hip Osteoarthritis

Your doctor will consider your complete medical history, results from your physical examination, and x-rays to determine the extent of joint damage and formulate a diagnosis of hip osteoarthritis. If more information is needed, an MRI (magnetic resonance imaging) may be ordered by your doctor. Blood tests may be used if it is necessary to rule out other types of arthritis.

According to the American College of Rheumatology classification criteria for osteoarthritis of the hip, there must be hip pain and at least 2 of the following 3 criteria:

• erythrocyte sedimentation rate < 20 mm/hr
• femoral or acetabular osteophytes seen on x-ray
• joint space narrowing seen on x-ray

Symptoms of Hip Osteoarthritis

Patients who have hip osteoarthritis have pain localized to the groin area and the front or side of the thigh. Morning stiffness, though for less duration than occurs with rheumatoid arthritis, is also characteristic of hip osteoarthritis.

Most significantly, there is limited range of motion of the hip and pain during motion. The symptoms can worsen to the point that pain is constantly present.

Treatment of Hip Osteoarthritis

Hip osteoarthritis cannot be cured, but there are treatments available to help manage symptoms. Treatment plans should be personalized to each patient, according to the American College of Rheumatology, and other conditions must be considered.

Medications are one way to treat hip osteoarthritis. For mild cases, acetaminophen is usually tried first. NSAIDs (nonsteroidal anti-inflammatory) and opioid analgesics are used for moderate to severe hip osteoarthritis.

There are also non-drug treatments that can help:

• weight loss (normal weight people have a 20% risk of hip OA, overweight have 25% risk, and obese have 39% risk)
• water exercise programs
• physical therapy (range of motion and strengthening exercises)
• occupational therapy (assistive devices, joint protection)
• patient education

Surgery is considered a last resort treatment option.

Surgery is appropriate for patients with hip osteoarthritis who have failed other more conservative treatment options. Surgical procedures include:

• arthroscopy - an arthroscope checks the condition of the articular cartilage
• osteotomy - realigns angles of the hip joint
• total hip replacement - new acetabular and femoral components are implanted

An accurate diagnosis and early treatment help decrease pain and improve function for the hip osteoarthritis patient. As the condition advances, appropriate treatment changes can be made.

_Sources:

_{A Patient's Guide to Osteoarthritis of the Hip. eOrthopod. Accessed 7/29/2007.
http://www.eorthopod.com/public/patient_education/6501/osteoarthritis_of_the_hip.html}

_{Guidelines for the Medical Management of Osteoarthritis. Osteoarthritis of the Hip. Arthritis & Rheumatism. Nov 1995.
http://www.rheumatology.org/publications/guidelines/oa-hip/oa-hip.asp}