The hip is a ball and socket joint in your pelvis that unfortunately with enough wear and tear can sometimes become worn out. There is articular cartilage on the end of the ball and in the socket that allow for a smooth rotation through the hip joint. Often patients will come in complaining of loss of range of motion. They may have noticed that they cannot put on their socks as easily as they used to or get up and down from a chair comfortably. Most patients will also complain that they have more discomfort in their hip or groin when they walk. Often times the pain will be more in the front of the hip and there may even be a clicking and catching in the front or anterior portion of the hip that seems to radiate down towards the knee.
With a good history, physical examination, and x-rays, a worn out hip can be detected. Most causes of a worn out hip include osteoarthritis which is a normal wear and tear pattern in the hip. There can be other causes such as rheumatoid arthritis or systemic inflammatory diseases. A history of prior injuries or trauma could also lead to the hip wearing out.
What are the treatment options for hip arthritis?
Most of the options for treatment of hip arthritis involve physical therapy to increase the strength in your trunk and back and around your hip. Occasionally anti-inflammatory medications will relieve some of the symptoms of stiffness and pain and a cortisone shot in the hip can also provide relief, however, this is temporary. Hip arthritis is often confused with hip bursitis which is actually an inflammation of the tissue outside of the hip joint and can hurt on the outer portion of the hip Bursitis is usually worse when someone lays on their side at night or when you get up and down from sitting for a prolonged period of time. This could be treated with physical therapy, injections and anti-inflammatories but usually does not require any surgical treatments or hip replacements. If you have hip bursitis, you may not even have hip arthritis.
When do I need hip replacement surgery?
Because we have no cure for hip arthritis, patients who have not had satisfactory improvement from nonsurgical treatments of their hip arthritis are often candidates for hip replacement surgery. With today’s technology and minimally invasive surgical techniques hip replacement surgery often will provide significant pain relief and improvement in activities of daily living. Many very active patients have had hip replacement surgery and resume their previous physical fitness activities with a new vigor after their hip replacement surgeries. There are some newer hip replacement procedures involving resurfacing or metal on metal bearings, however, these have not all proven themselves over time and the jury is still out on how long they will be successful. In my opinion hip replacement surgery has had a very long track record and is probably the most appropriate way to treat patients who have hip arthritis. Using new minimally invasive techniques, you are able to have a faster recovery and less pain after hip replacement surgeries. The surgery will generally take about an hour and the patients will only spend one or two days in the hospital. Often they are walking without any assistance within one to two weeks and back to many of their normal activities in four weeks. If you have questions about hip arthritis and hip replacement surgeries, please feel free to contact me or make an appointment.