Arthritis of the Hip 

Inflammatory arthritis occurs when the body’s immune system becomes overactive and attacks healthy tissues. It can affect several joints throughout the body at the same time, as well as many organs, such as the skin, eyes, and heart.

There are three types of inflammatory arthritis that most often cause symptoms in the hip joint:

• Rheumatoid arthritis
• Ankylosing spondylitis
• Systemic lupus erythematosus

Although there is no cure for inflammatory arthritis, there have been many advances in treatment, particularly in the development of new medications. Early diagnosis and treatment can help patients maintain mobility and function by preventing severe damage to the joint.

The most common form of arthritis in the hip is osteoarthritis — the “wear-and-tear” arthritis that damages cartilage over time, typically causing painful symptoms in people after they reach middle age. Unlike osteoarthritis, inflammatory arthritis affects people of all ages, often showing signs in early adulthood.

Rheumatoid Arthritis
In rheumatoid arthritis, the synovium thickens, swells, and produces chemical substances that attack and destroy the articular cartilage covering the bone. Rheumatoid arthritis often involves the same joint on both sides of the body, so both hips may be affected.

Ankylosing Spondylitis
Ankylosing spondylitis is a chronic inflammation of the spine that most often causes lower back pain and stiffness. It may affect other joints, as well, including the hip.

Systemic Lupus Erythematosus
Systemic lupus erythematosus can cause inflammation in any part of the body, and most often affects the joints, skin, and nervous system. The disease occurs in young adult women in the majority of cases.

People with systemic lupus erythematosus have a higher incidence of osteonecrosis of the hip, a disease that causes bone cells to die, weakens bone structure, and leads to disabling arthritis.

During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy.  Most injuries can be diagnosed with a thorough physical examination.

Imaging Tests Other tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.

The treatment plan for managing your symptoms will depend upon your inflammatory disease. Most people find that some combination of treatment methods works best.

Non-steroidal Anti-Inflammatory Drugs (NSAIDs). Drugs like naproxen and ibuprofen may relieve pain and help reduce inflammation. NSAIDs are available in both over-the-counter and prescription forms.

Corticosteroids. Medications like prednisone are potent anti-inflammatories. They can be taken by mouth, by injection, or used as creams that are applied directly to the skin.

Disease-Modifying Antirheumatic Drugs (DMARDs). These drugs act on the immune system to help slow the progression of disease. Methotrexate and sulfasalazine are commonly prescribed DMARDs.

Physical Therapy. Specific exercises may help increase the range of motion in your hip and strengthen the muscles that support the joint.

In addition, regular, moderate exercise may decrease stiffness and improve endurance. Swimming is a preferred exercise for people with ankylosing spondylitis because spinal motion may be limited.

Assistive Devices. Using a cane, walker, long-handled shoehorn, or reacher may make it easier for you to perform the tasks of daily living.

Hip replacement is one of the most important surgical advances of this century. This surgery helps more than 300,000 Americans each year to relieve their pain, and get back to enjoying normal, everyday activities. Hip replacement involves the removal of arthritic bone ends and damaged cartilage and replacing them with prosthetic implants that replicate the hip joint.

Hip replacement surgery may be considered when arthritis limits your everyday activities such as walking and bending, when pain continues while resting, or stiffness in your hip limits your ability to move or lift your leg.

Hip replacement may be recommended only after careful diagnosis of your joint problem. It is time to consider surgery if you have little pain relief from anti-inflammatory drugs or other treatments, such as physical therapy, do not relieve hip pain.

Hip replacement can help relieve pain and get you back to enjoying normal, everyday activities.

Total hip replacement is often reserved for patients who:

• Have a painful, disabling joint disease of the hip resulting from a severe form of arthritis
• Are not likely to achieve satisfactory results from less invasive procedures, such as arthrodesis (artificial stiffening or fixation of the joint)
• Have bone stock that is of poor quality or inadequate for other reconstructive techniques

In a total hip replacement operation, the surgeon replaces the worn surfaces of the hip joint with an artificial hip joint. The worn head of the femur (thigh bone) is replaced with a metal or ceramic ball mounted on a stem; the stem is placed firmly into the canal of the thigh bone at its upper end. The acetabulum (hip socket) is prepared and implanted with a metal cup and plastic or ceramic insert. The ball and insert glide together to replicate the hip joint.

The information found on this site is for general orthopedic purposes only. In a medical emergency please dial 911 or go to your nearest Emergency Room.