What is Arthritis of the Hip?
Arthritis of the hip is a disease which wears away the cartilage between the femoral head, or hip ball, and the acetabulum, or hip socket, causing the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded and uneven. The result is pain, stiffness and instability. In some cases, motion of the leg may be greatly restricted. The two most common types of hip arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis, which is one of the most common forms of arthritis is degenerative (i.e. it causes gradual deterioration) and although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.
It is usually confined to the large weight-bearing joints of the lower body, including the hips and knees, but may affect the spine and upper body joints, too. Patients with osteoarthritis often develop large bone spurs, or osteophytes, (also called bony projections) around the joint, further limiting movement.
Osteoarthritis of the hip is a condition commonly referred to as "wear and tear" arthritis. Although the degenerative process may accelerate i.e. the process of wear and tear may be faster in persons with a previous hip injury, many cases of osteoarthritis occur when the hip simply wears out. Some experts believe there may be a genetic predisposition in people who develop osteoarthritis of the hip. Abnormalities of the hip due to previous fractures or childhood disorders may also lead to a degenerative hip. Osteoarthritis of the hip is the most common cause for total hip replacement surgery.
The first and most common symptom of osteoarthritis is pain in the hip or groin area during weight bearing activities such as walking. People with hip pain usually compensate by limping, or reducing the force on the arthritic hip. As a result of the cartilage degeneration, the hip loses its flexibility and strength, and may result in the formation of bone spurs. As the condition worsens, the pain may be present all the time, even during non-weight bearing activities.
Before considering total hip replacement surgery, your doctor and you may try various non-surgical therapies. An appropriate weight reduction programme (i.e. weight loss) may be beneficial in decreasing force across the hip joint. However, weight reduction can be difficult for people with hip arthritis since the arthritis pain precludes them from increasing their activity and not burning calories. An exercise programme may be instituted to improve the strength and flexibility of the hip and the other lower body joints. Lifestyle and activity modification may be undertaken in an attempt to minimise the activities that are associated with hip pain. Medications that reduce inflammation and pain may be prescribed by your doctor and/or nutritional supplements may also be taken.
Assistive devices like a cane or a crutch can help to reduce the force transmitted through the hip joint during walking and thereby may help to decrease hip arthritis pain. If non-surgical treatment is unsuccessful, you and your surgeon may decide that a total hip replacement is the best available treatment option. During this discussion the surgeon will also discuss the benefits and risks associated with total hip replacements.
Unlike osteoarthritis which is a "wear and tear" phenomenon, rheumatoid arthritis is a chronic inflammatory disease that results in joint pain, stiffness and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.
Although the exact cause of rheumatoid arthritis is unknown, some experts believe that a virus or bacteria may trigger the disease in people having a genetic predisposition to rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease in which the synovial tissue of the joint is attacked by one’s own immune system. The onset of rheumatoid arthritis occurs most frequently in middle age and is more common among women.
The primary symptoms of rheumatoid arthritis are similar to osteoarthritis and include pain, swelling and the loss of motion. In addition, other symptoms may include loss of appetite, fever, energy loss, anaemia, and rheumatoid nodules (lumps of tissue under the skin). People suffering with rheumatoid arthritis commonly have periods of exacerbation or "flare ups" where multiple joints may be painful and stiff. Apart from orthopaedic surgeons, rheumatologists specialise in the treatment of rheumatoid arthritis. If you think that you may have this condition, please speak to your general practitioner who may refer you to a specialist.
Treatment of rheumatoid arthritis may involve medications, some of which are called "disease modifying" in that they change the way in which the disease progresses, and also pain killers. Treatment options include medicines, which could change the rate at which the disease advances, and address pain. Like all treatments, medicine may have risks and side-effects. If non-surgical measures fail, or are inadequate for your specific health condition, your doctor may propose further measures, which may be surgical in nature. These measures may help you improve your functional level and movement.