Osteoarthritis of the Hip

Structure and Function of the Hip Joint

The hip joint is one of the largest joints in the human body, connecting the femur to the pelvis. It is a ball-and-socket joint, meaning the head of the femur fits into the acetabulum of the pelvis. The hip joint transfers body weight from the trunk to the lower limbs and allows movement in various directions: flexion, extension, abduction, adduction, internal rotation, and external rotation. The hip joint is responsible for maintaining body balance and biomechanics – enabling walking, running, and jumping.

What is Osteoarthritis of the Hip?

Osteoarthritis of the hip, also called coxarthrosis, is a progressive condition that leads to the gradual destruction of the cartilage covering the bone surfaces within the hip joint. It is usually the result of prolonged wear and tear of the joint, leading to reduced function, pain, and stiffness.

Causes of Osteoarthritis of the Hip

• Age – Aging is one of the main risk factors for hip osteoarthritis. As we age, the body’s ability to regenerate damaged joint cartilage diminishes, leading to its gradual degradation.
• Excess weight – Individuals who are overweight are at higher risk due to increased stress on the hip joints, which can accelerate cartilage wear.
• Injuries – Various injuries, such as femoral neck fractures, can increase the risk of developing osteoarthritis of the hip later in life.
• Heredity – Genetic factors may play a significant role in the development of this condition. People with a family history of hip osteoarthritis may be more prone to its development.
• Rheumatic diseases – Conditions such as rheumatoid arthritis or other systemic diseases can lead to cartilage damage in the hip joint.
• Abnormal hip structure – Conditions such as developmental dysplasia of the hip and anatomical predispositions (e.g., femoroacetabular impingement) can lead to premature joint destruction and the development of degenerative changes.

Symptoms of Osteoarthritis of the Hip

The symptoms of hip osteoarthritis develop gradually and may include:

• Hip pain – (pain in the groin) Initially, the pain may be mild and occur only after intense physical activity, but as the disease progresses, it becomes more severe and may radiate. Pain can occur during daily activities and even at night.
• Stiffness – Patients may experience stiffness in the joint after resting for a while or immediately after getting out of bed, which makes movement difficult.
• Restricted range of motion – Limited mobility in the affected joint can cause difficulties in performing a full range of movements, affecting walking, standing up from a chair, or climbing stairs.
• Limping – Patients may develop a limp and a feeling of leg weakness. They may start avoiding weight-bearing on the affected joint, leading to a characteristic waddling gait.

Diagnosis of Osteoarthritis of the Hip

The diagnosis of hip osteoarthritis begins with a detailed medical history and physical examination by a doctor, who will consider current symptoms, medical history, and previous injuries the patient may have experienced. However, additional imaging tests are required to confirm the diagnosis and assess the severity of the condition.

• X-ray – Allows the evaluation of cartilage condition, joint space narrowing, and the presence of osteophytes (bone spurs).
• MRI – Provides highly detailed images of the hip joint, including cartilage, ligaments, the joint capsule, and other soft tissues.
• Ultrasound – Useful for assessing the joint capsule and surrounding soft tissues.
• Blood tests – Can help rule out other conditions, such as arthritis.

After conducting the appropriate tests and thoroughly evaluating the results, the doctor will be able to diagnose hip osteoarthritis and determine the stage of the disease. Early diagnosis allows for more effective therapeutic measures to alleviate symptoms and improve the patient’s quality of life.

Conservative Treatment of Osteoarthritis of the Hip

In the early stages of the disease, the orthopedist may introduce pharmacological treatment. Painkillers and anti-inflammatory medications can help relieve pain and inflammation. At this stage, physical therapy is essential. Manual therapy and specialized exercises can strengthen the muscles surrounding the hip joint, reducing joint load and improving mobility. Sometimes, the doctor may opt for intra-articular injections of hyaluronic acid or corticosteroids, which can provide pain relief and reduce inflammation in the hip joint.

Patient education is crucial during conservative treatment. Lifestyle changes such as weight reduction, avoiding prolonged joint stress, and regular exercises can help alleviate symptoms, slow disease progression, and improve joint condition. An experienced physiotherapist can assist the patient in selecting physical activities that are less stressful on the hip joint while maintaining an active lifestyle.

Rehabilitation in the Treatment of Osteoarthritis of the Hip

Rehabilitation plays a key role in the treatment of hip osteoarthritis. Its main goals are to alleviate pain, improve the range of motion and muscle strength, and maintain the highest possible hip function. An individually tailored rehabilitation program can significantly impact the patient’s quality of life and slow disease progression. Collaboration with an experienced physiotherapist is essential for achieving excellent rehabilitation outcomes in patients with hip osteoarthritis.

Manual therapy performed by qualified physiotherapists can help relax tense muscles and periarticular tissues, relieving pain and stiffness.
Strengthening exercises for the leg, hip, abdominal, and back muscles are essential for providing proper support and stabilization to the hip.
Stretching exercises can help maintain flexibility and range of motion in the hip joint, making daily activities easier.

Surgical Treatment of Osteoarthritis of the Hip

In advanced stages of hip osteoarthritis, when conservative treatment methods do not provide the expected results, the orthopedist may suggest surgical treatment. One of the most commonly performed surgical procedures is hip arthroplasty (total hip replacement), which involves replacing the diseased hip joint with an artificial implant. This is a very effective procedure, as the prosthesis can significantly relieve pain, restore mobility, and improve the quality of life.

Rehabilitation is an extremely important stage in returning to full functionality and health following hip arthroplasty. Immediately after surgery, the patient begins a rehabilitation program to strengthen muscles, restore range of motion, and learn proper gait. The physiotherapist introduces specialized exercises, which are gradually intensified as the patient’s condition improves.

Home Remedies for Hip Osteoarthritis

Home remedies for managing coxarthrosis can help alleviate pain, reduce inflammation, and improve the range of motion.

• Applying a warm compress can help relieve pain and stiffness in the hip joint, while cold compresses may be effective in reducing inflammation and swelling.
• Performing gentle stretching exercises can help maintain muscle flexibility and increase the range of motion.
• Regular strengthening exercises can help stabilize the hip.
• Weight reduction can decrease stress on the hip joint and reduce pain.
• Avoid prolonged sitting in one position, as it can lead to stiffness and pain in the hip joint.
• However, it is important to remember that these methods do not replace professional medical care. If you experience severe pain, mobility restrictions, or worsening symptoms, consult a doctor for a proper diagnosis and treatment plan.

Related Articles:

Learn about other possible causes of hip pain.

References:

• "Defining structural abnormalities of the hip joint at risk of degeneration" - Vickas Khanna, Paul E. Beaulé - Journal of Hip Preservation Surgery, Volume 1, Issue 1, July 2014, Pages 12–20,
• OrthoInfo - "Osteoarthritis of the Hip" - Contributed and/or Updated by Jared R.H. Foran, MD, FAAOS; Peer-Reviewed by Stuart J. Fischer, MD, FAAOS
• Cibulka MT, Bloom NJ, Enseki KR, MacDonald CW, Woehrle J, McDonough CM. Hip pain and mobility deficits—hip osteoarthritis: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy. 2017
• Lespasio MJ, Sultan AA, Piuzzi NS, Khlopas A, Husni ME, Muschler GF, Mont MA. Hip osteoarthritis: a primer. The Permanente Journal. 2018;22.