HIP OSTEOARTHRITIS: CAUSES, SYMPTOMS, TREATMENTS AND PREVENTION

Osteoarthritis, also known as “wear-and-tear arthritis,” is a common condition that many people experience as they age, particularly from the age of 50 and older. This condition can occur in any joint in the body but most commonly develops in weight-bearing joints such as the hip joint.
 

Hip osteoarthritis causes pain and stiffness in the joints, which can make performing daily activities such as bending down to tie shoelaces, getting up from a chair, or short-distance walking also becomes difficult. As osteoarthritis gradually becomes more severe over time, early detection and treatment can maximally limit the impact on the patient’s life. Although there is no complete cure for osteoarthritis, there are currently many treatment methods available to help you manage pain and maintain daily activities conveniently.

► What is hip osteoarthritis?

The hip joint (acetabulofemoral joint) is a ball-and-socket joint, with the head of the femur located within a socket formed by the acetabulum and the labrum. Hip osteoarthritis is the most common pathological condition at the hip joint, caused by the erosion of the articular cartilage layer due to various factors.

► Risk factors

• Age: The risk of developing osteoarthritis increases with age, commonly occurring in individuals over 50 years old.

• Gender: The incidence of hip osteoarthritis is higher in men under 50 years old; after 50, women are more affected by osteoarthritis. This condition can be explained by changes following menopause.

• Obesity: Excess body weight is a risk factor for osteoarthritis not only in weight-bearing joints but also in the hands. Excess weight creates increased load on the joints, but there is growing evidence of the metabolic contribution to osteoarthritis.

• Genetics: Numerous studies have shown that genetics plays an important role in the pathogenesis of hip osteoarthritis, and a twin study reported a 60% risk for hip osteoarthritis due to genetic factors.

• Occupation: Some related jobs involve heavy labor and high-impact sports activities that are associated with hip osteoarthritis and other joints. Repetitive stress and mechanical overload, especially in the condition of existing anatomical malformations of the hip joint, can also be potential causes. Laborers are prone to hip osteoarthritis due to the nature of their work.

► Causes

There is not a specific cause for osteoarthritis, but there are several factors that may increase your likelihood of developing this condition, including:

• Aging

• Family history of osteoarthritis

• Previous joint injuries

• Obesity

• Developmental dysplasia of the hip (DDH), also known as hip dysplasia or congenital hip dislocation.

► Symptoms of hip osteoarthritis
 

The most common symptom of hip osteoarthritis is pain around the hip joint. The pain in the hip progresses slowly and worsens over time, although sudden onset can also occur. Pain and stiffness in the joint may be more severe in the morning or after sitting or resting for a while. Gradually, the pain symptoms may occur more frequently, even at rest or during the night. Symptoms may include: 

• Pain in the groin or thigh radiating to the buttocks or knee

• Pain flares up during vigorous activity

• Hip joint stiffness makes walking or bending difficult

• There is a sensation of the joint not moving smoothly, with a cracking sound when moving due to fragments of cartilage and other tissues obstructing the movement of the hip joint

• Reduced range of motion in the hip joint affects walking ability and may cause limping

• Increased joint pain due to changes in weather

► Complications of hip osteoarthritis
 

Some complications that may arise from hip arthritis include:

• Severe joint injuries

• Severe joint pain

• Disrupted sleep quality

• Decreased work productivity

• Weight gain

• Anxiety and depression

• Osteonecrosis

• Intra-articular bleeding or infection

► Diagnosis of hip osteoarthritis

• Clinical examination: The specialist will check to determine if there are any signs indicating hip osteoarthritis. The doctor may ask you to move the hip joint gently in various ways and walk back and forth to see if the joint pain causes any changes in your gait, such as limping. Doctors may also gently press on the skin over the hip joint to check for tenderness or swelling.

• Radiography: Radiography is used to confirm the diagnosis of hip osteoarthritis. X-rays produce detailed images of the inside of the body and reveal results such as the narrowing of the cartilage layer in the hip joint. 

• MRI and Ultrasound: MRI and ultrasound can help doctors diagnose mild cases of osteoarthritis or identify soft tissue problems in the hip joint, such as labral tears, as well as assess whether there is synovitis. At the same time, ultrasound also helps identify fluid collections in the joint that cannot be seen on X-ray images. During the ultrasound process, high-frequency sound waves are used to create images of the internal structures of the body. This examination usually occurs simultaneously with a clinical examination at the doctor’s office. MRI uses magnetic fields and radio waves to produce detailed two- or three-dimensional images that allow doctors to examine the hip joint from various angles.

► Effective treatment

The main goal of treating hip osteoarthritis is to improve mobility (walking ability) and the patient’s lifestyle. Part of this goal includes improving hip joint function and controlling pain, such as:

•    Resting and caring for the joint

•    Using a cane to reduce weight on the affected hip joint

•    Non-pharmacological pain relief techniques to manage pain

•    Reducing excess weight

•    Exercising

•    Medications, including acetaminophen (Tylenol), non-steroidal anti-inflammatory drugs like ibuprofen (Advil), or prescription pain relievers

•    Surgery

► Some notes for patients after treatment

Patients with hip osteoarthritis need support from relatives to improve treatment effectiveness and speed up recovery. To help patients improve their quality of life, caregivers need:
 

•    Understand the patient’s medical condition to identify the exact problems that need support. For example, patients with late-stage hip osteoarthritis will need help transitioning from a sitting to a standing position.

•    Have an open mind and share concern and care for the patient.

•    Only support the patient when really necessary, it is important to create conditions for the patient to perform daily activities on their own.

•    Help the patient take medication at the right time and in the correct dose as prescribed by the doctor.

•    Learn how to use some assistive devices such as crutches, walkers, etc., to support the patient in using them.

•    Encourage the patient to exercise and engage in physical activity with moderate and appropriate intensity.

► Effective disease prevention
 

One method to effectively prevent hip osteoarthritis is to maintain a reasonable body weight.
 

Additionally, you should exercise regularly. Exercise helps strengthen the muscles around the joints. Such strengthening can help prevent wear on the cartilage in the joints.

At the American International Hospital (AIH) Orthopedic Department, we provide various treatment solutions for musculoskeletal disorders: from diagnosis, conservative treatment, surgery, and rehabilitation.
 

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