Inflammatory Arthritis of the Hip

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.

Cause

The exact cause of inflammatory arthritis is not known, although there is evidence that genetics plays a role in the development of some forms of the disease.

  • Arthritis of the Hip
  • Avascular Necrosis (Osteonecrosis)
  • Bursitis of the Hip
  • Degenerative Joint Disease
  • Femur Shaft Fracture
  • Hip Fracture
  • Femoroacetabular Impingement Syndrome
  • Gluteus Medius Tear
  • Inflammatory Arthritis of the Hip
  • Labral Tear of the Hip
  • Loose Bodies of the Hip
  • Muscle Strains of the Thigh
  • Snapping Hip
  • Strains of the Hip
  • Synovitis
  • Transient Osteoporosis of the Hip

  • Bone Grafting of the Hip
  • Core Decompression of the Hip
  • Direct Anterior Hip Replacement
  • Femoroacetabular Impingement Surgery
  • Hip Arthroscopy
  • Minimally Invasive Hip Surgery
  • Posterior Total Hip Replacement – VERILAST
  • Revision Total Hip Replacement
  • Total Hip Replacement Surgery – VERILAST

The Orthopedic physicians at Peninsula Bone & Joint Clinic provide conservative treatment options for Hip conditions and injuries.

Symptoms

Inflammatory arthritis may cause general symptoms throughout the body, such as fever, loss of appetite and fatigue. A hip affected by inflammatory arthritis will feel painful and stiff. There are other symptoms, as well:

  • A dull, aching pain in the groin, outer thigh, knee, or buttocks
  • Pain that is worse in the morning or after sitting or resting for a while, but lessens with activity
  • Increased pain and stiffness with vigorous activity
  • Pain in the joint severe enough to cause a limp or make walking difficult

Diagnosis

Physical Examination & Patient History

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

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.

Treatment Options

Non-Surgical

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.

Surgical

If nonsurgical treatments do not sufficiently relieve your pain, your doctor may recommend surgery.

The type of surgery performed depends on several factors, including:

  • Your age
  • Condition of the hip joint
  • Which disease is causing your inflammatory arthritis
  • Progression of the disease
  • The most common surgical procedures performed for inflammatory arthritis of the hip include total hip replacement and synovectomy.

Total Hip Replacement. Your orthopaedic surgeon will remove the damaged cartilage and bone, and then position new metal or plastic joint surfaces to restore the function of your hip. Total hip replacement is often recommended for patients with rheumatoid arthritis or ankylosing spondylitis to relieve pain and improve range of motion.

Direct Anterior Approach to Total Hip Replacement (Arthroplasty).

The Direct Anterior Approach for total hip replacement is a tissue-sparing alternative to traditional hip replacement surgery that provides the potential for less pain, faster recovery and improved mobility because the muscle tissues are spared during the surgical procedure.

The technique allows the surgeon to work between the patient‘s muscles and tissues without detaching them from either the hip or thighbones—sparing the tissue from trauma.
Keeping the muscles intact may also help to prevent dislocations.

With the Anterior Approach, the surgeon uses one small incision on the front (anterior) of your hip as opposed to the side or back. Since the incision is in front, the patient avoids the pain of sitting on the incision site.

Traditional Total Hip Replacement.

In a traditional total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.

The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.
A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

Synovectomy. Synovectomy is done to remove part or all of the joint lining (synovium). It may be effective if the disease is limited to the joint lining and has not affected the articular cartilage that covers the bones. Generally, the procedure is used to treat only the early stages of inflammatory arthritis.

Conservative Treatment Options

  • Non-Operative Hip Injury Treatments

Treatment Highlights

VERILAST Hip Replacement Technology

Innovative Implant Design

Smith Nephew VERILAST hip replacement implant.

It’s important to remember that not every hip implant is the same. The Smith Nephew VERILAST Hip Technology is the one technology that directly addresses two of the most commonly cited concerns associated with hip replacement implants:

  • Implant Wear

  • Implant Fracture

Peninsula Bone & Joint Clinic

The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.
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Disclaimer

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.