Hip osteoarthritis is a joint disease caused by the wear and tear of cartilage in the hip joint over time, leading to groin pain, limited mobility, and difficulty walking. While medication, exercise, and physical therapy are used in the early stages, total hip replacement may be considered in advanced cases.
What is hip osteoarthritis?
Hip osteoarthritis, also known medically as hip degeneration, occurs when the cartilage tissue covering the hip joint surfaces thins and deteriorates over time.
The hip joint is formed between the rounded head of the femur (thigh bone) and the socket in the pelvis. Healthy cartilage allows these two bone surfaces to move smoothly and with low friction.
When cartilage structure deteriorates, joint movements can become difficult. In later stages, hardening of the bone surfaces, bone spurs, narrowing of the joint space, and loss of movement may occur.
What causes hip osteoarthritis?
Hip osteoarthritis often doesn’t develop due to a single cause. Age, hip structure, past illnesses, and the load on the joint can all contribute.
Advanced Age
As we age, the ability of joint cartilage to regenerate may decrease. Therefore, hip osteoarthritis is more common in older adults.
Congenital Hip Development Disorders
Congenital structural problems such as hip dislocation or shallow hip socket can cause uneven loading on the joint surfaces.
This situation can predispose individuals to hip osteoarthritis, even at a young age.
Past Fractures and Injuries
Fractures around the hip, traumas affecting the joint surface, and previous surgeries can increase the risk of osteoarthritis in later years.
Impaired Blood Supply to the Hip
In a condition known as femoral head avascular necrosis, blood flow to the head of the thigh bone is disrupted. The collapse of the bone structure can eventually lead to osteoarthritis.
Excess Weight
Excess weight can increase the load on the hip joint. The pressure on the joint increases especially during prolonged standing and walking.
Genetic predisposition
People with a family history of hip osteoarthritis may be at increased risk.
Rheumatic Diseases
Inflammatory rheumatic diseases such as rheumatoid arthritis can affect the hip joint, leading to cartilage loss.
What are the symptoms of hip osteoarthritis?
The most common symptom of hip osteoarthritis is pain. However, the pain is not always felt directly on the outside of the hip.
The most common complaints are:
- Pain in the groin area
- Pain in the front or side of the hip
- Pain radiating to the thigh and knee.
- Increased discomfort while walking.
- Difficulty putting on socks and shoes
- Difficulty getting in and out of the car
- Stiffness after sitting for a long time
- Reduced hip movement
- limping
- Night pain and pain during rest
Because pain in hip osteoarthritis can radiate to the knee, some patients may think the problem originates in the knee.
How does hip osteoarthritis begin?
Hip osteoarthritis progresses slowly in most patients. In the early stages, pain may occur after long walks, using stairs, or strenuous activity.
Pain that decreases with rest may become more frequent over time. The patient may have difficulty with everyday activities such as putting on socks, tying shoes, or bending down.
In later stages, walking distance may decrease, limping may develop, and pain may affect sleep at night.
How is hip osteoarthritis diagnosed?
For diagnosis, the patient’s complaints are listened to in detail and an orthopedic examination is performed.
During the examination;
- The area where the pain is located,
- Hip range of motion,
- Walking style,
- Leg length,
- Muscle strength,
- Other problems that may originate from the back and knees.
It is evaluated.
X-ray
The most commonly used imaging method for evaluating hip osteoarthritis is X-ray.
X-rays may show narrowing of the joint space, bone spurs, hardening of the joint surface, and changes in bone structure.
MRI Imaging
MRI is not necessary for every patient. An MRI may be requested if impaired blood flow to the hip joint, early-stage cartilage damage, muscle-tendon problems, or another underlying condition is suspected.
Computed Tomography
Computed tomography (CT) scans can be used in cases where a more detailed examination of bone structure is required.
In Mako robotic hip replacement planning, a three-dimensional model of the patient’s hip joint can be created using tomography data.
What are the stages of hip osteoarthritis?
Hip osteoarthritis can be mild, moderate, or severe.
Early Stage Hip Osteoarthritis
Pain typically occurs after long walks and strenuous activity. Mild restriction of hip movement may be present.
Moderate Hip Osteoarthritis
Groin pain is more common. Activities such as putting on socks, tying shoes, and getting into a car may become difficult.
Advanced Hip Osteoarthritis
The joint space narrows significantly. Pain may persist even at rest, limping may develop, and daily life may be severely restricted.
X-ray images alone do not determine treatment decisions. The patient’s pain level and quality of life are also taken into consideration.
How is hip osteoarthritis treated?
Hip osteoarthritis treatment is planned according to the severity of the disease, the patient’s age, weight, and limitations in daily life.
The goal is to reduce pain, preserve mobility, and enable the patient to perform daily tasks more comfortably.
Non-Surgical Hip Osteoarthritis Treatments
In early and middle-stage disease, non-surgical methods may be applied first.
Exercise and Physical Therapy
Strengthening the muscles around the hips can help balance the load on the joint.
Exercises that maintain range of motion, such as controlled walking, swimming, and low-impact activities like stationary cycling, may be recommended.
Weight Control
In overweight patients, weight loss can help reduce the load on the hip joint.
Daily Life Arrangements
Prolonged standing, heavy lifting, and repetitive movements that increase pain can be reduced.
Using a cane can reduce the load on the joint in some patients. The cane is usually held in the hand on the opposite side of the painful hip.
Drug Treatments
Pain relievers and anti-inflammatory drugs can be used. These medications should not be used for extended periods without a doctor’s recommendation.
In individuals with stomach, kidney, heart, and vascular diseases, medication selection should be done carefully.
Intrahip Injections
In some patients, injections can be administered into the hip joint under imaging guidance.
Cortisone Injection
It can be used to reduce inflammation and pain within the joint. Its effect may be temporary.
Other Injections
Treatments such as hyaluronic acid or PRP may be considered for some patients. However, these methods do not regenerate lost cartilage and do not completely eliminate advanced osteoarthritis.
Because the hip joint is located deep within the body, injections may need to be administered under ultrasound or X-ray guidance.
Can hip osteoarthritis completely go away?
It is not possible to completely restore worn cartilage to its original state with medication.
However, in the early stages, pain can be reduced and mobility preserved with exercise, weight management, physical therapy, and appropriate medication.
The goal of treatment is to reduce the patient’s symptoms and improve their quality of daily life.
When is surgery necessary for hip osteoarthritis?
Hip replacement surgery is not performed solely because osteoarthritis is detected on X-rays.
Surgery may be considered in the following situations:
- Pain seriously affecting daily life
- Significant reduction in walking distance.
- Onset of pain at night and at rest
- Severe restriction of hip movement
- Difficulty putting on socks and shoes
- limping
- Lack of sufficient benefit from medication and physical therapy.
- Imaging revealed advanced joint wear.
The decision for surgery is made by considering the patient’s complaints, age, general health status, and expectations.
What is Total Hip Replacement?
Total hip replacement involves replacing worn hip joint surfaces with artificial joint components.
The damaged head of the femur is removed and replaced with a metal or ceramic head. The hip socket is also prepared to accommodate the prosthetic components.
The goal is to reduce pain, increase hip range of motion, and improve the patient’s walking ability.
Robotic Hip Replacement
Robotic hip replacement is the personalized planning of total hip replacement surgery with the support of a robotic system.
In the Mako robotic system, a three-dimensional hip model is created from the patient’s computed tomography images.
The surgeon is using this model;
- The structure of the hip socket,
- The appropriate size of the prosthesis,
- The angle of the socket piece,
- The placement location of the prosthesis,
- Leg length and hip balance
They can evaluate it before the surgery.
The robot does not perform the surgery on its own. The surgeon controls the robotic arm and inserts the prosthesis.
3D Planning in Mako Robotic Hip Replacement
The position and angle of the socket component in hip replacement surgery are important. Improper placement can affect hip movement and the stability of the prosthesis.
The Mako system helps in the detailed preoperative planning of prosthesis placement through a tomography-based three-dimensional model.
The surgeon can evaluate different prosthesis sizes and positions on the digital model. During the operation, the robotic system supports the controlled execution of the prepared plan.
Hip Replacement Recovery Process
The post-operative recovery process can vary depending on the patient’s age, muscle strength, overall health, and the surgical method used.
Patients can be mobilized early under the supervision of the healthcare team. Walking exercises are initiated with the guidance of a physiotherapist.
In the first period;
- Pain control,
- Wound monitoring,
- Preventing blood clots,
- The use of a walker or crutches,
- Doing the exercises recommended by the doctor,
- Avoid movements that put strain on the hips.
It is important.
Are there any risks associated with hip replacement surgery?
Hip replacement surgery, like other surgical procedures, carries some risks.
Potential risks include:
- Infection
- Bleeding
- clot formation
- Blood vessel or nerve injury
- hip dislocation
- Leg length difference
- Loosening around the prosthesis
- Ongoing pain
- Problems related to anesthesia
It may be included.
Before surgery, the patient’s individual risks are assessed and necessary precautions are planned.
How long do hip replacements last?
The lifespan of a hip replacement can vary depending on the patient’s age, weight, activity level, bone quality, and the placement of the prosthesis.
Regular check-ups, maintaining a healthy weight, and adherence to doctor’s recommendations affect the long-term success of the prosthesis.
No lifetime warranty can be given for any prosthetic device.
Hip Osteoarthritis Treatment in Adana
When planning hip osteoarthritis treatment in Adana, the cause of the pain, the level of wear and tear in the joint, and the limitations in the patient’s daily life are all evaluated together.
In the early and middle stages, exercise, physical therapy, weight management, and medication can be beneficial. In advanced osteoarthritis, total hip replacement may be considered.
At Adana Ortadoğu Private Hospital, the Mako robotic surgical system allows for tomography-based robotic hip replacement planning in suitable patients.
Hip Osteoarthritis Treatment with Op. Dr. Muhsin Dursun
Op. Dr. Muhsin Dursun evaluates patients in the fields of hip osteoarthritis, total hip replacement, and robotic prosthetic surgery at Adana Ortadoğu Private Hospital.
Treatment planning considers the patient’s pain level, hip mobility, walking capacity, imaging findings, and expectations for daily life.
In patients for whom non-surgical methods are sufficient, conservative treatments are applied, while in suitable patients with advanced joint wear, robotic or conventional hip replacement options can be evaluated on an individual basis.
When should you see a doctor for hip pain?
If groin or hip pain persists for more than a few weeks, affects walking, or makes daily activities difficult, an orthopedic specialist should be consulted.
Medical evaluation should be sought immediately, especially if there is inability to bear weight after a fall, sudden and severe pain, fever, redness, or significant loss of movement.
Early examination doesn’t automatically mean surgery. It allows for the identification of the cause of the pain and ensures timely initiation of appropriate treatment.
