Hip Joint Osteoarthritis
Osteoarthritis (OA), often referred to as ‘wear-and-tear’ or ‘degenerative joint disease’, is a condition in which the surfaces within your joints become damaged so the joint doesn’t move as smoothly as it should. As the cartilage degenerates, the space between the acetabulum and femur (ball and socket) narrows and the bones begin grinding against each other. Osteophytes (bony spurs) may form which can then create more friction in the joint.
Not all hip OA is related to the aging process. Young people can develop secondary hip OA from trauma, congenital dysplasia and developmental disorders, infection, metabolic conditions, and other causes
Symptoms of Hip Joint Osteoarthritis
- Aching pain in the groin and may refer down the thigh. It may also be felt on the side of hips, buttocks or back of thigh.
- Pain with certain movements such as bending to put shoes or socks on or twisting to get out of a car.
- Aggravated when rising from a seated position, particularly from a low chair.
- Stiffness and reduced range of movement within the hip joint.
- Grinding sensation within the hip joint
Anatomy of the hip joint
The hip is a synovial ball and socket joint and allows for articulation between the ball-shaped femoral head and the socket of the acetabulum. The ball and socket shape allow for motion and supports the weight of the body.
How to diagnose
A diagnosis can be developed by one of our expert physiotherapists by taking a thorough history and performing a series of physical tests.
An X-RAY can be used to assess the stage of arthritis – if it is mild, moderate or severe. It is important to note that the severity of arthritis found on the XRAY does not always correlate to the level of pain. A study of 978 people found that 25% of males had OA changes on an XRAY but only 5% had pain. 13% of females had OA signs but only 3% had pain (Kim et al, 2014).
A hip replacement is not the only option when treating hip osteoarthritis
Osteoarthritis of the hip joint can be well managed with conservative treatment and not require surgical intervention. Research has found a 33% improvement in function with physiotherapy exercises and weight loss combined (Paans et al, 2013).
Unfortunately, once the joint space has narrowed significantly, we must work within our limits. There is no amount of stretches that will improve range of movement or change pain as a result.
Things you can do to help yourself:
- Physiotherapy prescribed progressive strengthening exercise program. Building the strength around the hip will reduce the pressure on the joint and slow down the progression of osteoarthritis.
- Rest or activity modification to reduce aggravation of pain.
- Losing weight will make a significant improvement to pain in function by reducing the stress on the joint.
- Take simple over the counter pain relief such as paracetamol or ibuprofen
- Topical anti-inflammatory gel
hip Joint Osteoarthritis Injection therapy
Injection therapy performed under ultrasound guidance can be used to improve pain and function for those with pain caused by hip osteoarthritis. This may be appropriate if symptoms are not improving with physiotherapy alone, if the pain is affecting your sleep or the pain is stopping you from performing your rehab plan.
Ultrasound-guided corticosteroid injection
Steroid injections use a small dose of corticosteroid (a strong anti-inflammatory drug) and are injected under ultrasound-guidance into the hip joint. Ultrasound guided steroid injections can be very effective for reducing hip joint pain and inflammation. As a result, this improves function, allows better exercise tolerance and delays the need for surgery.
Ultrasound-guided Hyaluronic acid injection
Hyaluronic acid (HA) is a gel-like substance that is naturally present throughout the human body and provides lubrication to eliminate friction of the joints. Injecting hyaluronic acid into a joint essentially helps lubricate the joint and works as a transport medium for nutrients.
Ultrasound-guided Platelet Rich Plasma (PRP) injection
PRP has become increasingly popular in the treatment of Osteoarthritic joints. It involves taking your own blood, usually from a vein in your arm and then using a centrifuge to separate the blood constituents. The next step is extracting the plasma from the separated blood which has up to 5 x the number of platelets and growth factors which are a key ingredient in tissue regeneration. This is then injected into the hip joint. It is popular as it does not involve any drugs and is using your own bodies cells to reduce symptoms which can last up to 1 year.
Daniels, E.W., Cole, D., Jacobs, B. and Phillips, S.F., 2018. Existing Evidence on Ultrasound-Guided Injections in Sports Medicine. Los Angeles, CA: SAGE Publications.
Kim, C., Linsenmeyer KD., Vlad, S.C, Guermaxi, A., Clancy, M., Niu, J. and Felson, D.T. (2014) Prevalence of radiographic and symptomatic hip osteoarthritis in an urbal United States community: the Framingham osteoarthritis study. Arthritis Rheumatology. 66(11). pp . 3013-3017.
Paans, N., Akker-Sheek, I., Dilling, R.G., Bos, M., Meer, K., Bulstra, S.K. and Stevens, M. (2013) Effect of exercise and weight loss in people who have hip osteoarthritis and are overweight or obese: a prospective cohort study.Physical therapy. 93(2). Pp.137-146.