Hip - Osteoarthritis
Description
Arthritis is inflammation of a joint. Over time, the loss of the smooth covering on the ends of bones (aka - articular cartilage) causes pain and stiffness. This can lead to pain with motion or at rest, clicking or grinding and a loss of strength. When the cartilage is damaged or decreased, the bones rub together during joint motion, resulting in “bone-on-bone” arthritis. When arthritis becomes severe, inflammation occurs around the joint and extra bone is formed in an attempt to protect the joint, resulting in limited motion and strength.
What are the causes?
The primary cause of arthritis is osteoarthritis (aka – “wear and tear” arthritis). Trauma and other illnesses like rheumatoid arthritis, systemic lupus, septic arthritis and psoriasis can result in degeneration of a joint, leading to symptoms of pain and lack of motion.
What are the symptoms?
Arthritis causes pain (particularly in the groin area), loss of motion and strength. Clicking and grinding may be felt inside the hip. If severe enough, walking may be altered due to pain.
How is it diagnosed?
Arthritis is diagnosed by your physician based on physical exam and X-rays. Your orthopedic surgeon will examine your hip, noting range of motion, strength and pain with motion. Your surgeon may order additional diagnostic tests to evaluate all hip structures (CT/”CAT” scan) to evaluate the bones and joints or MRI to evaluate the muscles, tendons and ligaments.
Non-operative
Hip arthritis can be treated with physical therapy, to strengthen the muscles that support the joint. Aggressive physical therapy is not suggested for advanced hip arthritis, as it may aggravate symptoms. Your surgeon may prescribe anti-inflammatory medication or offer an injection to reduce the inflammation. Certain nutritional supplements may be beneficial to decrease pain and inflammation.
Platelet-rich plasma (PRP) injection is another non operative option for treating pain. Blood is taken from your arm and is spun down to get the healthiest healing factors - platelets and serum. The goal is to promote an anti-inflammatory effect, reduce pain, and stimulate healing. There is also the potential for joint preservation by slowing down the arthritic process. Although one injection may help, studies support a series of 2 injections, 1 x Week/2 weeks. Not covered by insurance.
Bone Marrow Concentrate "Stem Cell" Injections is another non operative option for treating pain. Bone marrow is aspirated from your pelvis and centrifuged in a special kit to concentrate stem cells, which are then re-injected into the joint. The goals are to change the living micro-environment of the joint to a positive one, and to decrease inflammation and cartilage cell death. Will promote healing of cartilage, will not re-grow cartilage, restore joint space, or remove bone spurs. There is also great potential for joint preservation by slowing down the arthritic process in early stages. Not covered by insurance.
Operative
When non-operative treatment does relieve symptoms, surgery may be indicated in certain situations. Minimally –invasive hip arthroscopy is not indicated for most patients with hip arthritis. The definitive treatment for hip arthritis is joint replacement surgery. Your surgeon will resurface the ends of the bone where the cartilage has worn away, with metal and plastic implants.
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Recovery
After any type of surgery for osteoarthritis of the hip, there is a period of recovery. Recovery time and rehabilitation depends on the type of surgery performed.
Your doctor may recommend physical therapy to help you regain strength in your hip and to restore range of motion. After your procedure, you may need to use a cane, crutches, or a walker for a time. In most cases, surgery relieves the pain of osteoarthritis and makes it possible to perform daily activities more easily.