What Is Hip Osteoarthritis?

The hip is one of the most important joints in the body. Its primary purpose is to bear and support the weight of the body during physical activity.

A two-part “ball and socket” joint, the hip is the connection between the thighbone and the pelvis. The pelvic bone forms the socket, called the acetabulum, and the tip of the thighbone forms the ball, called the femoral head. Ligaments — bands of tissue — connect the ball to the socket. This creates the joint capsule. Lining the joint capsule is the synovium, a thin membrane that produces fluid to lubricate the hip joint. In addition, bursae, or fluid-filled sacs, cushion the muscle, tendons, and bones in the hip joint. The surfaces of the ball and socket are covered with cartilage, a slippery substance that cushions the bones and enables them to move smoothly.

In some cases, constant use of the hip causes the cartilage to degrade, which interrupts the smooth movement of the joint. This is called hip osteoarthritis. The condition worsens as deterioration increases. As a result of hip osteoarthritis, it becomes more difficult for the hip joint to function properly.

What Are The Symptoms Of Hip Osteoarthritis?

Generally, the cause of hip osteoarthritis is not known, but contributing factors include age, weight, a prior hip injury, extra stress on the joint, heredity, or structural problems with the hip, such as hip dysplasia.

Before you can be diagnosed with hip osteoarthritis, an orthopedic physician will need to review your medical history, conduct a physical examination, assess your overall health, and order imaging of the hip. There are four stages of hip osteoarthritis:

STAGE 1. MINOR OSTEOARTHRITIS. There is some wear and tear on the hip joint, but not enough to cause discomfort. Typically, no treatment is recommended, but patients with a genetic predisposition to osteoarthritis may be advised to take supplements (glucosamine and chondroitin) and/or adopt a regular exercise program.
STAGE 2. MILD OSTEOARTHRITIS. This is the stage in which patients begin to experience hip pain and stiffness, usually upon waking in the morning, during or after exercise, or when sitting for an extended period of time. Typically, X-rays will reveal the start of bone spurs (a tiny outgrowth of bone usually caused by inflammation) and minimal breakdown of the cartilage in the hip.
STAGE 3. MODERATE OSTEOARTHRITIS. Imaging reveals more obvious erosion of the hip cartilage, which narrows the gaps between the ball and socket of the hip. Bone spurs are also more prevalent. Normal activities, such as running or walking, are painful. Stiffness and pain also occur when rising or sitting for long periods of time. In addition, the hip may begin to snap or pop when moving.
STAGE 4. SEVERE OSTEOARTHRITIS. At this point, pain or stiffness in the hip makes walking or bending difficult, if not impossible. There is increased pain after physical activity, and pain may radiate from the hip to the buttocks or knees. In addition, the hip joint may lock or stick, and/or creak when the hip is moved. Imaging will reveal that the cartilage in the hip joint has broken down, and the space between the bones is severely decreased or non-existent.

How Is Hip Osteoarthritis Treated?

While there is no cure for hip osteoarthritis, it is treatable. Early treatment can slow the progression of osteoarthritis, eliminate pain, and improve hip mobility.

Non-surgical treatment options include:

MEDICATION. Use of over-the-counter or prescription pain relievers or anti-inflammatory drugs to reduce or eliminate pain. If non-steroidal anti-inflammatory drugs (NSAIDs) prove ineffective, corticosteroids may be used to reduce inflammation of the hip joint.
LIFESTYLE MODIFICATIONS. Limiting or eliminating activities and situations that aggravate hip osteoarthritis. For example, switching from high-impact to low-impact exercise, reducing the frequency of climbing stairs, or losing weight.
PHYSICAL THERAPY. Developing an individualized exercise program that increases flexibility, strength, and range of motion. Tai chi, yoga, cycling or a stationary bike, swimming, water exercise, and walking are among the commonly recommended forms of exercise. Regular stretching helps relieve pain and stiffness in the hip joint.
ASSISTIVE DEVICES. Using tools, such as a long-handed reacher, sock aid, or dressing stick, to minimize movements that cause hip pain. Other assistive devices, including canes, crutches, or walkers, can also aid mobility.

If non-invasive strategies fail to alleviate the problems caused by hip osteoarthritis, surgery may become an option. Typically, it will be recommended when the pain and stiffness from hip osteoarthritis limit mobility or cause disability.

Three types of surgery are available:

HIP RESURFACING. In this procedure, damaged bone and cartilage in the hip socket is removed. It is replaced with a metal, plastic, or ceramic shell. To ensure ease of movement, the femur is then capped with a similar material.
TOTAL HIP REPLACEMENT. The damaged ball and socket are removed and replaced with metal, plastic, or ceramic parts.
OSTEOTOMY. In this rarely used procedure, the thighbone or socket is cut and realigned to alleviate the pressure on the hip joint.

Complications are possible with any type of surgery. The most common complications of hip surgery are excessive bleeding, blood clots, infection, hip dislocation, varying limb length, and blood vessel or artery damage.

The recovery time for hip surgery depends on the overall health of the patient and the type of surgery performed. Typically, the patient will be encouraged to use the repaired hip as quickly as possible, utilizing an assistive device, such as a walker or cane.