Hip Arthritis

What is Hip Arthritis?

The hip joint can become worn-out most commonly as a result of osteoarthritis but may also result from other causes such as trauma, infection or other diseases.

Just like a car’s wheel that is not balanced or aligned properly can cause premature tyre wear, a hip joint’s mechanical function can be affected by disease causing faster degeneration.

Arthritis is a condition in which the hip’s articular cartilage that covers the joint surface is damaged or worn out causing pain and inflammation.

Causes of Hip Arthritis

Patients with arthritis experience pain, stiffness, and loss of movement. This is due to:

The progressive wearing of articular cartilage,
Narrowing of the joint space, and
The possibility of bone spurs or excessive bone growth around the edges of the hip joint.

Causes of arthritis include:

Natural Degeneration
Cartilage Wear Due to Advancing Age
Congenital or Developmental Hip Diseases
Weight Issues
Previous History Of Hip Injury Or Fracture
Increased Stress On Hip Because Of Overuse

Degenerative Arthritis (Osteoarthritis)

The Hip Joints can become worn-out most commonly as a result of osteoarthritis.

Cartilage Wear

As the hip cartilage is degraded over time due to osteoarthritis it will not regenerate. This condition typically will not improve over time and can be painful and debilitating.

Hip Fractures

Older patients are more prone to hip fractures and deformities caused by osteoporosis as patients bones become less dense with tissue loss and more soft and brittle. Fractures around the hip may lead to post-traumatic arthritis requiring hip replacement.

Femoral Acetabular Impingement (FAI)

Femoral acetabular impingement (FAI) has been suggested as a cause of premature osteoarthritis. This may be the reason we see younger and younger patients developing arthritis.

Genetic

There may be a genetic tendency in some people to develop osteoarthritis. Abnormalities from some hip conditions can appear in childhood and can lead to earlier degeneration. This mechanical abnormality causes excessive wear and tear

Rheumatoid Arthritis

While Rheumatoid Arthritis’ trigger is unknown, the swelling caused by inflammation of synovial joints can cause pain and ultimately joint degeneration. If the condition can not be treated with medication it can give rise to Hip Replacement Surgery.

Avascular Necrosis

Can cause degeneration of the hip joint. This disease can cause blockage of the artery to the femoral head. Starved of nutrients the hip’s femoral head dies and may collapse.

Avascular necrosis (AVN) can cause degeneration of the hip joint. Most cases are without a known underlying cause. Some cases are related to medications such as corticosteroids. Excessive alcohol consumption can also lead to AVN.

Perthes’ Disease

Perthes’ disease mainly affects children (3 - 11 year olds). The disease softens the femur ball due to a poor blood supply. While most Perthes’ disease sufferers recover and regenerate bone, the disease can leave lasting damage.

Slipped Capital Femoral Epiphysis

Early development problems of the femoral head can give rise to hip problems for patients in their teens. The ball slides out of position causing the leg to turn outward. Contributing factors to this condition include increased hormones and weight gain with age.

Without treatment, slipped capital femoral epiphysis can worsen and the child may experience arthritis of the hip joint in later life.

Dysplasia and Congenital Dislocation

Developmental problems of a newborn’s joint can cause dislocations because of a shallow socket. This form of dysplasia prevents a stable fit. Causes for developmental dysplasia include breech births, family history and other disorders such as spina bifida.

Slack ligaments may also allow the femoral head to slip out of the joint. Dysplasia is also linked to long term use of cortisone medication.

Ankylosing Spondylitis

While an uncommon form of inflammatory arthritis it can affect hips.

Typical symptoms include pain and stiffness first thing in the morning. Ankylosing spondylitis can occur by itself or in association with other disorders, including Crohn’s disease, ulcerative colitis and psoriasis.

Symptoms of Arthritis of The Hip

Common Arthritis symptoms include:

Pain In The Hip Joint (particularly In The Groin)
Pain Radiating Pain From The Hip To Thigh And Knee
‘Clunking’ In The Hip
Difficulty Walking Resulting In A Limp
Muscle Stiffness

The pain is often made worse with simple activity like putting weight through the hip such as when arising from a chair.

Hip pain can also be felt down the front of the leg, and buttock (although pain in this area can also be caused by problems with the lower back). This is called referred pain, and it’s fairly common.

Other prolonged symptoms can include:

Loss Of Full Range Of Motion
Inability To Either Bend Or Fully Straighten The Hip
A Tendency For Your Hip To Get "stuck" Or Lock Up
Audible ‘clicking’ Or A Sense Of ‘grating’
Difficulty Putting On Shoes And Socks

Diagnosis of Hip Arthritis

Your doctor will need to diagnose the specific nature of your hips disorder or the extent of any osteoarthritis in the Hip joint, a clinical diagnosis is made by:

Taking a Medical History
Performing a Medical Examination
Joint Range of Motion Assessment
Pathology Testing but there is no blood test for osteoarthritis

Imaging tests - In order to clearly understand the nature of the condition imaging scans may be required:

X-rays - do not show cartilage but are often normal as they can help rule out other problems with the Hip that may have similar symptoms like fractures (broken bone), ACL injury, joint space, bony spurs and arthritic cysts
MRI - can create detailed images of both hard and soft tissues within your Hip. An MRI can produce cross-sectional images of internal structures required if the diagnosis is unclear or if other soft tissue injuries are suspected such as ligament injuries, articular cartilage wear, and also labral tears
Ultrasound - can allow the doctor to examine the inside of your Hip in motion. This can help determine if you have a loose flap of cartilage getting caught between the moving parts in your Hip.

While not all of these approaches or tests are required to confirm the diagnosis, this diagnostic process will also allow your doctor to review any possible risks or existing conditions that could interfere with the surgery or its outcome.