Coxarthrosis, Osteoarthritis of the Hip, Degenerative Hip Disease……..another great example of the medical profession using loads of words when a few will do! These are all synonyms for one of the commonest conditions affecting the human skeleton – Hip Arthritis!
As part of our larger series on conditions affecting the hip, Mr Simon Newman, one of our hip arthritis specialists, answers some of your commonest questions on this important topic.
What is hip arthritis and have I got it?
Every year we take between 1 and 1.5 million steps with each leg. Your hips are vital to this mobility and when they become painful it has a big impact on your life. The commonest issue affecting hips is osteoarthritis, this is what most people refer to as “arthritis”.
What is hip arthritis?
The hip joint consists of a ball at the top of the thigh bone (femur) and a socket (acetabulum) within the pelvis. The ball and the socket are lined with a layer called articular cartilage. This articular cartilage layer is very slippery and lets your joint move smoothly. For an in depth look at hip anatomy, please see here.
When you have arthritis the articular cartilage layer has worn away ultimately resulting in contact between the underlying bony surfaces. Articular cartilage has no nerve endings, but progressive loss of cartilage results in increased stress on the bone around the joint which does have pain sensors. As the hip becomes stiffer, the muscles, tendons and hip capsule have to work differently and may also contribute to the pain you feel. As the osteoarthritis progresses, the bone around the hip becomes denser, fluid filled cysts can develop in the bone and extra bone may form that further restricts movement of the joint.
What causes hip arthritis?
In most people we do not know exactly why osteoarthritis has developed, though in many people it does seem to run in families suggesting there is a genetic cause. However, there are a number of conditions that can lead to osteoarthritis, these include: hip dysplasia (underdeveloped hip joint), femoroacetabular impingement (where the thigh bone and pelvis bump into each other), fractures around the hip and avascular necrosis (softening and collapse of the ball of the hip). Inflammatory arthritis, such as rheumatoid arthritis, can also cause osteoarthritis. For a detailed review of the cases of hip arthritis, please see here.
What are the symptoms of hip arthritis?
The symptoms of hip osteoarthritis usually come on gradually with pain in the groin, thigh, buttock or even around the knee. This is often associated with a limp and a progressive restriction of movement that makes tasks that involve bending down, like putting your socks and shoes on, more difficult. Pain at night-time is also very common. Pain in the lower back can often be present with hip osteoarthritis, but the pain is not generated by the arthritic hip. However, when your hip is stiff your back has to work harder to compensate, which may exacerbate wear and tear related pain in the lower back.
How is it diagnosed?
The diagnosis of hip osteoarthritis is usually on the basis of the symptoms you describe and a physical examination. A simple pelvic x-ray is usually all that is required to confirm the diagnosis.
In the next blog in this series, Simon discusses non operative management strategies for Hip Arthritis.
If you are concerned that you may have hip osteoarthritis and would like to find out more, please get in contact and make an appointment to see one of our hip specialists.