Hip osteoarthritis

Osteoarthritis of the hip occurs when day-to-day exertion causes the protective layer of cartilage on the bones in the hip joint to wear away. This results in an increase in the pressure on the bones and over time there is a reduction in the mobility of the hip joint. Osteoarthritis of the hip is most common in people over the age of 45.

Symptoms

Osteoarthritis of the hip develops over a long period of time. The first signs are hip joint pain after a day of heavy exercise. The individual may also experience pain when walking and climbing stairs. Pain that occurs when moving the thigh inward is very significant.

The changes in the hip joint caused by osteoarthritis of the hip can also result in joint stiffness, restricted movement and flare-ups of pain.

Causes

Factors that cause the protective layer of cartilage to become increasingly worn include, for example, obesity, accidents, congenital malposition (hip dysplasia), as well as sports or professions that place particular stress on the joints. Ageing also plays a major role. Loss of elasticity and water retention in the cartilage increases strain and accelerates cartilage loss.

Factors that contribute to osteoarthritis of the hip:

  • being extremely overweight
  • family predisposition
  • strenuous physical work
  • inflammatory joint diseases
  • hip impingement

Diagnosis

There is a set of typical symptoms that can help to diagnose osteoarthritis of the hip. These include ‘start-up pain’ and ‘morning stiffness’.

During the examination, the hip is palpated and its mobility examined. The doctor will also check the angle of the pelvis and whether the legs are of different lengths.

X-rays, ultrasounds or blood tests are used if the doctor suspects that other diseases may be present or needs to rule out a bone fracture. 

The cartilage damage is divided into different stages of osteoarthritis, according to the extent of the wear.

Superficial damage (small tears) of the articular cartilage can occur, but there are also types of damage that affect the entire cartilage. This damage exposes the surface of the bone and causes pain.

Cartilage damage is divided into four stages:

  • Stage 1: soft cartilage
  • Stage 2: rough surface with cracks
  • Stage 3: deep cracks in the cartilage that go to the bone
  • Stage 4: complete deterioration of cartilage with exposed bone

Treatments

Conservative therapies

If the osteoarthritis of the hip joint is still in the early stages, it can be treated conservatively. In this case, special shoe inserts, shoes with cushioned soles or walking sticks are used in an attempt to relieve the joint. Cartilage-supporting and pain-relieving drugs are also prescribed to counteract the pain.

The progression of osteoarthritis can also be influenced by adopting better lifestyle habits. Losing excess weight and low-impact exercise such as cycling are beneficial. However, the osteoarthritis itself cannot be stopped or cured by conservative measures.

Hyaluronic acid injections

The hyaluronic acid preparation acts as a synthetic lubricant and is injected directly into the joint. The extra lubrication reduces the friction on the cartilage surface and improves the mobility of the joint. This also reduces joint inflammation.

Injections of lubricant vary in effectiveness, depending on how advanced the osteoarthritis is. Hyaluronic acid injections allow the majority of patients to regain a good proportion of their quality of life.

Cortisone injections

The human body makes its own cortisone to reduce inflammation. Injecting synthetically manufactured cortisone uses the properties of the body’s own cortisone to relieve pain. Because the synthetically produced cortisone dissolves more slowly, the effect lasts longer. However, cortisone also has side effects. It can attack bone and cartilage and weaken tendons. It also suppresses your immune system and therefore increases the risk of infection.

Surgical treatment

If the conservative measures are not helpful and the pain in the hip persists, an artificial hip joint, i.e. a hip prosthesis, can be considered.

Thanks to the advanced method of keyhole surgery, which helps to preserve the tissue, the stabilising hip muscles are only pushed to the side, rather than being severed as they were before. In this minimally invasive procedure, the artificial hip joint is introduced from the front.

An incision of about eight centimetres is made in the skin, through which the artificial hip joint is inserted without injuring the tissue.

The hip operation takes up to two hours and the hospital stay is around five days.

FAQs

Which movement training can be used with osteoarthritis of the hip?

The following exercises and sports help to keep the hip joints moving gently:

  • yoga
  • endurance training with regular movements, e.g. cycling or swimming
  • water aerobics
  • stretching exercises

Do I need to lose weight if I have osteoarthritis of the hip?

If you are very overweight, it is recommended that you lose weight, as this also relieves the pressure on the joints.

What else do I have to consider if I have been diagnosed with osteoarthritis of the hip?

The first priority is to alleviate pressure from the joints. It is therefore important to wear well-fitting shoes with cushioned soles. If the osteoarthritis of the hip is already advanced and you have reduced mobility, walking aids are recommended.

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