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Hip Arthritis: The basics

Hip osteoarthritis is a common but disabling condition affecting the hip joint, that results in pain, and limitation of movement and function.

Hip osteoarthritis can be primary (with no obvious cause) and secondary due to an underlying abnormality that causes abnormal loading and cartilage loss over years to eventually cause arthritis.

Unlike knee arthritis, primary osteoarthritis of hips is rarer compared to secondary arthritis. In certain populations such as India, China, primary hip osteoarthritis is extremely rare.

There are a number of secondary causes of osteoarthritis. These include Avascular necrosis of the hip, Developmental dysplasia of the hip, Perthes disease, Slipped upper femoral epiphysis, fractures & dislocations around the hip, and infection (septic arthritis). We will discuss each of these conditions in detail in subsequent blogs.

Arthritis of the hip needs to be differentiated from referred pain from the spine and this is possible with a good history and examination along with appropriate imaging.

The simplest investigation to diagnose hip arthritis is a plain X-ray of the hips.

The arthritic changes are quite obvious on the right hip with reduced joint space (due to loss of cartilage which is translucent on xrays), sclerosis of bones (whiter appearance) and cyst formation in the bone.

The treatment depends on a number of factors but mainly dictated by how the patients quality of life is affected by pain and limitation of function, night pain and disturbed sleep, walking distance, etc.

Treatment in the initial stages is conservative with use of analgesia, crutches to offload the hip, physiotherapy to improve muscle strength and conditioning, and weight reduction.,

If these measures fail, then the treatment is total hip replacement.

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