Hip Osteoarthritis
Everything about the causes, symptoms, treatments, and prognosis of progressive degeneration of the pelvis-femur joint.
Symptoms and causes
Hip osteoarthritis is a degenerative disease affecting the joint that connects the femur to the pelvis. When it occurs, the cartilage progressively wears down, impairing movement and causing the bones to rub against each other. In advanced stages, stiffness or ankylosis may occur, resulting in loss of mobility.
There are four grades of hip osteoarthritis that determine its severity:
- Grade I osteoarthritis: the joint functions normally, but there is slight narrowing of the joint space.
- Grade II osteoarthritis: the cartilage shows evident wear, affecting the range of motion.
- Grade III osteoarthritis: the cartilage is severely damaged, causing joint instability and loss of mobility.
- Grade IV osteoarthritis: the cartilage is almost completely gone, the joint space is minimal, and the bones rub against each other, resulting in nearly nonexistent movement and intense pain.
Hip osteoarthritis has no cure; treatments aim to improve patients’ quality of life and reduce dependency in advanced stages of the disease.
Symptoms
Characteristic symptoms of hip osteoarthritis include:
- Pain mainly in the groin, which may radiate down the leg.
- Stiffness, especially in the morning.
- Inflammation.
- Difficulty walking.
- Formation of osteophytes, small bony deformities around the joint.
- Reduced range of motion.
- Limping.
- Loss of mobility.
Causes
Hip osteoarthritis can be classified into two types depending on the underlying cause:
- Primary osteoarthritis: there is a genetic predisposition contributing to joint wear.
- Secondary osteoarthritis: results from trauma, injury, repetitive use of the joint, vascular damage, leg length discrepancy, or misalignment of the legs (knees turned inward or bowlegs).
Risk Factors
The likelihood of developing hip osteoarthritis increases in the following cases:
- Age: more frequent in older adults due to natural joint wear.
- Sex: more common in women.
- Previous trauma, injuries, or hip surgeries.
- Repetitive joint use.
- Family history.
- Uncontrolled diabetes, as hyperglycemia may damage cartilage.
- Obesity, since the hip bears excess weight.
- Rheumatic diseases negatively affecting cartilage structures.
Complications
The most common complications of hip osteoarthritis are:
- Chronic pain.
- Limited mobility.
- Difficulty performing daily activities.
- High level of dependency.
- Depression.
Prevention
Although hip osteoarthritis cannot be prevented, its progression can be slowed and symptoms reduced by following these recommendations:
- Maintain a healthy weight.
- Walk daily with regular breaks.
- Practice low-impact sports, such as swimming, cycling on flat terrain, or Pilates.
- Avoid standing for prolonged periods.
- Do not lift heavy weights.
Which Doctor Treats Hip Osteoarthritis?
Hip osteoarthritis is primarily diagnosed and treated by specialists in traumatology and orthopedic surgery. Depending on the disease, rheumatology, geriatrics, or pain management specialists may also be involved.
Diagnosis
In most cases, hip osteoarthritis is clinically diagnosed:
- Medical history: review of patient and family medical background along with presenting symptoms.
- Physical examination: observation and palpation of the joint, assessing response to pressure and range of motion.
Imaging tests help confirm the diagnosis and determine the degree of joint involvement. Typically, an X-ray is performed to evaluate the condition of the hip tissues. If higher detail is required, a Resonancia magnética (RM) or a Computed Tomography (CT) Scan may be used.
Treatment
Treatment of hip osteoarthritis varies depending on patient needs and disease progression. The most effective treatments include:
- Analgesics to relieve pain.
- Anti-inflammatory drugs to reduce swelling.
- Acupuncture to control pain and inflammation if pharmacological treatment is insufficient.
- Hyaluronic acid injections to improve joint lubrication and protect the bones.
- Osteotomy: a surgical procedure in which the bone is cut to reposition it and redistribute load.
- Arthroscopy: instruments are inserted through two or three small incisions to remove damaged cartilage or excise osteophytes.
- Hip arthroplasty: surgery performed when pain and limited mobility prevent a normal life. The femoral head and damaged cartilage are replaced with a prosthesis, which may be total or partial.
