Hip Osteoarthritis
Einstein Health Glossary
ICD 10 - M16
What is hip osteoarthritis?
Hip osteoarthritis is a degenerative disease of the hip joint, highly limiting for the patient and generally chronic. It involves the wear of the articular cartilage (bone-on-bone contact), formation of cysts, sclerosis, and osteophytosis (bone spurs), as well as bone deformities.
All these changes lead to a local inflammatory process with pain, reduced joint mobility, and consequently, a loss in quality of life.
Causes and Types
Hip osteoarthritis can be caused by two types of changes:
- metabolic: wear caused by specific or nonspecific inflammatory processes that lead to cartilage degeneration. Good examples include joint infection and rheumatoid arthritis
- mechanical: changes in the shape of the articulating structures (femoral head vs. acetabulum), often linked to childhood diseases that caused joint deformation, or loss of joint congruence in cases of pelvic fractures (acetabulum)
Severity
The degree of osteoarthritis considers the amount of wear and cartilage loss. Generally, the greater the damage, the more significant the pain and disability.
Signs and Symptoms
The main symptom of hip osteoarthritis is pain. When pain is associated with loss of movement, it leads to reduced joint function.
In more severe cases, symptoms may include limb shortening, joint stiffness, limping, and difficulty with basic activities such as sitting on the toilet or experiencing pain when changing sides during sleep.
Diagnosis
Diagnosis of osteoarthritis is made through a thorough orthopedic consultation that values clinical data and includes a careful physical examination. Once suspected, the orthopedist initially requests simple X-rays of the pelvis and hip. Most cases are diagnosed this way. If there are doubts or a need for further clarification, other tests such as CT scans or MRIs may be requested.
Prevention
As previously mentioned, the causes of osteoarthritis can be mechanical or metabolic. Therefore, the most important aspect of preventing disease progression is early diagnosis of the underlying cause of joint wear.
Some systemic inflammatory diseases can be controlled, preventing or delaying hip degeneration. Thus, as soon as pain or joint activity limitation appears, a specialized evaluation should be sought.
Treatment
Treatment of osteoarthritis depends on the degree of joint involvement. In milder cases, where pain is occasional and linked to specific activities, a more conservative approach may be attempted, including physical therapy and rehabilitation, with routine adjustments to fit the patient’s reality.
Physical therapy, medications, and even assistive devices like canes may be used.
In more advanced cases, surgical treatment becomes the best option. In such cases, total hip arthroplasty (hip replacement) is the solution.
Although it is a major surgery, hip arthroplasty is now well-established and yields excellent results when best practices are followed. Success depends on several factors: proper surgical indication, thorough preoperative evaluation, adequate hospital infrastructure, quality materials, and a surgeon who is up-to-date with the latest techniques.
Postoperative recovery is usually quick, considering the scale of the surgery. Pain is typically managed with medication, and shortly after surgery, the patient can walk well again. The best advice is: if you experience hip pain, seek a specialist!