Hip Issues

Osteoarthritis
There are several causes of hip arthritis. Arthritis applies to pain within a joint secondary to inflammation. There are many causes of hip arthritis, the most common of which are degenerative arthritis, the basic wear-and-tear that occurs with age; traumatic arthritis which is arthritis secondary to an injury. Arthritis can also be a consequence of abnormality in the development of the hip joint such as syndromes called developmental dysplasia of the hip, slipped capital femoral epiphysis, and acetabular impingement. All these entities can result in hip arthritis. The symptoms associated with hip arthritis can be varied, the most common of which is groin pain. Groin pain is that pain that occurs deep in the joint that most people described as where the hip meets the body. Sometimes the pain can be located on the outside of the hip and even in the back of the hip. Patients will state that they have a tight feeling within their hip joint. They may describe night pain or activities of daily living. Most patients will tell you that they have a reduction in their activity level and that they can't do the things they used to do and want to do. In today's world, we're trying to become more active and stay healthier for a longer period of time. So, arthritis of the hip is becoming more prevalent. Currently, in this country about 250,000 hip replacements are done per year with an anticipated 20% growth per year for the next ten years. What are some of the findings associated with hip arthritis? They include pain with turning the hip in and out, otherwise called rotation. People have pain with walking or they may even have a limp. This limp can be described as an antalgic gait. Oftentimes, they will have a contracture which is where they lose range of motion within the hip joint. The most common types of contractures seen with arthritis of the hip are called an adduction contracture and a flexion contracture where the hip is slightly up. This can result in back pain and other-sided leg pain. What you will also see on physical exam is that the patient's leg will be slightly shorter than the other leg. There are several treatment options for arthritis of the hip joint.

The first is always conservative which includes activity modification, the use of a cane, and the use of medication such as anti-inflammatories. Regarding surgical options, there are a number of them. They include hip arthroscopy for people who don't have severe arthritis, but may have just the presence of a loose body in their hip joint; osteotomies, where you actually change the direction of the hip joint to take the area of arthritis and move it so that the area that the weight is going through is no longer arthritic, is also an option; and finally, hip replacements. There are a number of types of hip replacements: cemented, uncemented, and resurfacing hip replacements. The one that is done is oftentimes the one that is best suited for the patient's anatomy, meaning the type of bone they have.