ARTHRITIS OF THE HIP

OSTEOARTHRITIS OF THE HIP

The leading cause of disability in the elderly and most common joint disorder is osteoarthritis of the hip. Over two hundred thousand total hip replacements are done each year.  Five percent of everyone over 65 has osteoarthritis of the hip.

 Osteoarthritis begins with articular cartilage degenerating followed by growth at the joint margins and inflammation of the joint synovial fluid.

The examination shows increased pain in the hip when the hip is rotated and the knee is extended straight. Groin pain and tenderness occur in both hips 20 % of the time.  

An x-ray while standing will confirm the diagnosis.  There will be some loss in the joint space.  An MRI will show the same changes and is usually not necessary.

Treatment is to preserve hip function and relieve pain. Exercise doesn’t help much but water exercise shows improvement in 70 percent of the patients.

Acupuncture in a randomized controlled study resulted in significant pain reduction and 40 percent improvement of quality of life scores after three months of treatment. The benefit remained after another three months of follow up. 

Other treatments include acetaminophen and NSDAIDS to relieve pain and help hip function. It seems glucosamine chondroitin and injections of hyaluronic acid are little or no value.

The ultimate answer is total hip surgery with one year therapy after surgery.   I find putting a heel lift in the shoe on the affected side improves sense of balance and takes some weight off the arthritic hip.

Prevention of this problem includes: avoiding marathon running, prolonged standing, and avoiding lifting and moving of heavy objects. All of these can hasten andincrease risks, and aggravate the disease.

 The ultimate solution is don't grow old!

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