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Causes, Symptoms, and Treatment of Hip Osteoarthritis

Updated on April 16, 2013

Osteoarthritis of the hip is a very disabling disease. Osteoarthritis of hip is a disease responsible for the breakdown of cartilage in the hip joint

Coxarthrosis is osteoarthritis of the hip joint. Coxarthrosis Primitive is called when there is no malformation responsible for osteoarthritis and secondary osteoarthritis in the opposite case.

Causes of hip osteoarthritis

Primary osteoarthritis of the hip: is the most common cause. It affects adults, from 60 years. This form of arthritis is idiopathic, i.e. unexplained.

Secondary osteoarthritis of the hip: Some factors may increase the risk of osteoarthritis of the hip:

Osteonecrosis of the femoral head: This is the primary necrosis (unknown cause) of the femoral head.

Aftermath of fractured neck of femur or pelvis: a femoral neck fracture can lead to osteoarthritis of the hip when we meet one of the following problems:

Poor adherence of the femur: Poor adherence corresponds to a fracture that is consolidated with imperfect reduction. The resulting deformation can cause mechanical pain in the joint.

Fractures of the pelvis in the articular surface (acetabulum) can also cause secondary osteoarthritis.

The malformation of the hip (dysplasia): Hip dysplasia or congenital dislocation of hip abnormalities occur early in life and can be detected in utero by a sonographer with experience. At present, early treatment can correct these distortions, either orthopedic treatment or corrective surgery for children. Patients, who have not been treated in time, can develop early osteoarthritis of the hip.

Symptoms of hip osteoarthritis

The symptoms are the same as those of osteoarthritis of the hip, both primary and secondary.

Pain is the main symptom. It's a mechanical pain that is accompanied by lameness. This is usually located in the groin, but also can be placed on the gluteus or be revealed through a knee injury.

Rhythm: pain occurs mainly standing (mechanical pain), but can also be inflammatory (pain at night), or mixed.

Evolution: most often develops gradually pain, with a slow decline for several years. It can be seen during this period of climate change or painful episodes after excessive effort.

Joint stiffness associated with pain is responsible for a disability that is also evident discomfort when walking and limping.

Diagnosis

The examination by the doctor reveals a limitation of hip motion.

Clinical examination:

The examination will take place, standing and lying, so comparison with the healthy side:

1 ft / Revision:

Lameness: The study of the way in the presence of a limp. Two types of lameness can be isolated:

The limp dodge: occurs when the support is painful. This is a limp "reflection" to avoid the painful support.

The limp due to lameness by muscular failure occurs when the muscles of glutes are atrophied

The radiograph of both hips is essential for diagnosis.

Medical Procedure to treat osteoarthritis of the hip

The diagnosis is based on the pain points and examination of the hip, and confirmed with radiographs. Treatment includes nonpharmacologic measures, drugs and, finally, a resource to surgery

Medical treatment and rules of life:

Dietary rules:

Balanced diet, weight loss if there is an overweight. With the support of a nutritionist can recommend at this stage.

Walk with a cane for painful periods.

Medical treatment: In the initial stages, treatment analgesic and anti-inflammatory will be offered during painful periods classics.

Anti-arthritic: These treatments are often prescribed for osteoarthritis, with efficiency usually moderate.

Radiofrequency therapy may include improving inflammatory painful episodes.

Mesotherapy, acupuncture, etc...

Infiltration Hips: in case of failure of medical treatment, we recommend the application of infiltration under radiographic control of the hip. This gesture is performed by a radiologist. Products can be injected corticosteroids or hyaluronic acid.

Corticosteroids: Powerful anti-inflammatory effect observed with efficiency in the short and medium term.

The hyaluronic acid (viscosupplementation) is a viscous liquid, whose physiological properties allow supplementation of missing cartilage. Infiltration by up to one year may be proposed. In general, half of the patients responded positively to treatment efficacy. Based on the results, this treatment can be renewed annually.

The total hip prosthesis is in case of hip osteoarthritis. This works well for pain and osteoarthritic patient autonomy.

Surgery was contemplated when the disability becomes important

In some cases, given the importance of pain and its impact on daily life, a surgical solution is studied. Then, the doctor refers the patient to a surgeon. There are several hip surgeries.

Conservative surgery

An osteotomy (or establishing a bone graft placed near the joint to protect it) interventions are reserved for specific cases.

Prosthesis

In most cases, total hip replacement is implemented. There are many types of prostheses. For this implant is best suited to the patient's choice reflects his state of health, age, the anatomical shape of the hip.

Medical care and rehabilitation after surgery

Anticoagulation is required for approximately 6 weeks to prevent phlebitis and pulmonary embolism. An early patient mobilization is a key factor in a favorable because it maintains and improves muscle function and joint mobility.

Its purpose is to allow the patient to recover the activities of daily life as soon as possible. Such recovery is initiated by the therapist as soon as possible after surgery in the hospital. The therapist explains the actions should not do exercises to do at home between therapy sessions. These sessions are held, if all goes well, in the therapist's office or at home.

Possible complications of surgery for osteoarthritis of the hip

After surgery, complications can sometimes occur:

Bone or joint infection;

Dislocation;

Acetabular wear or loosening (failure of the fixation of the prosthesis to the bone)

The most common complication leading to a resumption of pain is due a Loosening of the femoral component.

The disadvantages of surgery too late:

General health status: waiting too long, vital functions may be affected (heart failure, respiratory failure, etc ...), making surgery too dangerous. Sometimes the danger is such that surgery is contra-indicated in patients with severe pain, with a life expectancy of several years. These situations are very common unfortunately.

Bone destruction: a very advanced osteoarthritis can sometimes cause significant bone destruction.

Deficiency muscle: the gluteus muscles (small, medium and large) are the stabilizing muscles of the hip. In osteoarthritis too advanced, these muscles can cause atrophy and irreversibly persistent lameness after the introduction of the prosthesis.

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