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Hip Arthritis

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Sometimes called "wear-and-tear" arthritis, osteoarthritis is a common condition that many people develop during middle age or older.

The most common symptoms of hip osteoarthritis are hip pain and decreased range of motion. Hip osteoarthritis often progresses gradually and many sufferers may try to ignore the signs until daily activities are affected.

Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure for osteoarthritis, there are many treatment options to help you manage pain and stay active.

Anatomy

The hip is one of the body's largest joints. It is a "ball-and-socket" joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone).

The bone surfaces of the ball and socket are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones and enables them to move easily.

The surface of the joint is covered by a thin lining called the synovium. In a healthy hip, the synovium produces a small amount of fluid that lubricates the cartilage and aids in movement.

Description

Osteoarthritis is a degenerative type of arthritis that occurs most often in people 50 years of age and older, though it may occur in younger people, too.

In osteoarthritis, the cartilage in the hip joint gradually wears away over time. As the cartilage wears away, it becomes frayed and rough, and the protective joint space between the bones decreases. This can result in bone rubbing on bone. To make up for the lost cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes).

Osteoarthritis develops slowly and the pain it causes worsens over time.

Cause

Osteoarthritis has no single specific cause, but there are certain factors that may make you more likely to develop the disease, including:

The most common cause of chronic hip pain and disability is arthritis. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are the most common forms of this disease.

Avascular Necrosis is a common condition leading to secondary Osteoarthritis. The blood supply to the ball part of the joint (femoral head) is cut off due to various reasons and this leads to weakening of the bone and eventually arthritis. Steriod use, warranted or unwarranted, is the most common cause in India.

Rheumatoid Arthritis is a disease in which the synovial membrane becomes inflamed, produces too much synovial fluid, and damages the articular cartilage, leading to pain and stiffness.

Osteoarthritis usually occurs after age 50. The articular cartilage covering & cushioning the bones of the hip wears away. The bones then rub against each other, causing hip pain and stiffness.

Traumatic Arthritis can follow a serious hip injury or fracture. A hip fracture can also cause avascular necrosis described above.

Even if you do not have any of the risk factors listed above, you can still develop osteoarthritis.

Symptoms

Pain in the hip, groin, back or thigh. Aching and stiffness in the groin, buttock or thigh can be a sign of hip osteoarthritis. Many people experience pain in the side or back of the hip when the hip bears weight. This pain may radiate down the thigh and even cause pain in the knee. Discomfort is usually most noticeable when getting out of bed in the morning and may flare up when participating in sports or other intense activities. Pain may subside with rest.

Decreased range of motion. Normally, the hip’s ball-and-socket construction allows for a wide range of motion. Hip osteoarthritis may make it particularly difficult to spread the legs apart, extend the leg straight back, or to point toes inward and move the entire leg in that direction (internal rotation).

Hip crunching or popping. A crunching or popping feeling can be a sign of bone-on-bone friction caused by hip osteoarthritis14. One hip osteoarthritis patient described the sensation of corn flakes in his hip joint when he got up in the morning or began exercise."Locking" or "sticking" of the joint, and a grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip

Limping or lurching. Hip osteoarthritis can make walking painful. To minimize the pain, people may limp or lurch forward—often unconsciously—to avoid putting pressure on the affected hip.Decreased range of motion in the hip that affects the ability to walk and may cause a limp

Loss of hip joint function. Daily activities that involve bending, such as putting on socks and shoes, can be very difficult or impossible for someone with hip osteoarthritis. Getting in and out of chairs or cars may also pose a challenge.

Inactivity makes it worse. Hips can become stiff after sleeping or sitting for a long period of time. People with hip osteoarthritis often find stiffness and pain are most noticeable when they try to get out of bed in the morning or out of a chair after a long period of sitting.

Who needs Total Hip Replacement Surgery ?

Patients eligible for this surgery have moderate to severe arthritis in the hip, including osteoarthritis, rheumatoid arthritis or post-traumatic arthritis, that causes pain and/or interferes with daily living. For example:

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  • Walking, going up stairs, and bending to get in and out of chairs is difficult
  • Pain and functional disability due to knee or hip joint;
  • Pain is moderate to severe even while resting, and may affect sleep
  • Joint degeneration has caused stiffness that affects the patient’s range of motion during normal activities; the patient may also have a limp
  • Symptoms are not adequately alleviated by non-surgical treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, or the use of a cane or walker
  • Advanced joint disease demonstrated by radiographic supported evidence or when conventional radiography is not adequate, magnetic resonance imaging (MRI) supported evidence (subchondral cysts, subchondral sclerosis, periarticular osteophytes, joint subluxation, joint space narrowing, avascular necrosis);
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