Many people suffer from hip problems due to osteoarthritis of the hip in the course of their lives. As a result, their quality of life is significantly reduced. The resulting effects also have a significant impact on the ability to carry out professional work. This also causes significant economic damage.
What is hip arthrosis?
Schematic representation Difference between healthy joint, arthritis and arthrosis.
According to abbreviationfinder, hip arthrosis is a disease of the hip joint in which the cartilage layer between the hip socket and the femoral head shows signs of wear. Wear and tear is mostly due to age. However, it can also occur as a result of injury or illness. As a protective lubricating layer, the cartilage tissue prevents the bones from painfully rubbing against each other and wearing away in the process.
Cartilage is an elastic connective tissue that has water-storing properties. The natural aging process reduces elasticity and water retention. Similar to the visible skin changes caused by the formation of wrinkles, there is also a change inside the body. The articular cartilage becomes smaller and rougher. The loss of cartilage height also causes a reduction in cushioning capacity.
The progression of this degenerative development process causes a functional limitation of the hip joint. In addition, there is increasing pain when the affected joint is subjected to stress. The duration and intensity of the pain can vary. The symptoms can even subside temporarily before pain sets in again, which then occurs at night even without exertion.
Causes
The cause of hip arthrosis can be very different and cannot always be clearly diagnosed. In the majority of cases, the natural aging process is the cause of the disease. Hereditary factors such as congenital deformities can accelerate this process.
In addition, diseases such as rheumatism, gout, bacterial infections as well as femoral head necrosis and osteoporosis can be the causal cause of coxarthrosis. Accidents can also lead to hip arthrosis. A pelvic fracture or a femoral neck fracture with a joint impairment can be the trigger for the onset of the disease. This changes the natural statics of the joint and causes greater stress on the cartilage.
Medication can also be responsible for osteoarthritis of the hip joint. Persistent, one-sided overloading of the hip joint over a longer period of time can promote hip arthrosis. Significant, permanent obesity also leads to this overload effect. Another reason for triggering osteoarthritis of the hip can be a lack of exercise, which leads to insufficient blood flow to the cartilage. The production of cartilage smear is reduced by disrupting the passive metabolism.
Symptoms, Ailments & Signs
Osteoarthritis of the hip begins with hardly noticeable symptoms. At the beginning there is slight pain, which is noticed by those affected, especially during physical movement. After a short time, the pain also occurs during periods of rest. Activities such as getting out of the car or climbing stairs become increasingly difficult and eventually no longer possible at all.
Then the joints also hurt at rest and at night and the pain often radiates to the knees and lower back. Arthrosis of the hip joints is mainly expressed by initial pain in the hip area, which subsides after a few steps. In the advanced stage, joint pain, groin pain and pain at rest occur.
The mobility of the thighs is severely restricted – often the legs can only be bent, stretched or spread with great effort. Externally, hip arthrosis can be noticed in the sluggish, often rocking gait. Those affected move much more slowly than usual and also have to take regular breaks.
In individual cases, hip arthrosis can manifest itself as redness and swelling in the hip area. Accompanying the physical symptoms, there are usually also psychological complaints such as increased irritability or depressive moods.
Diagnosis & History
Restrictions in hip function, which are often accompanied by painful sensations in the leg, back or buttocks, indicate the onset of osteoarthritis of the hip. If arthrosis is suspected, the patient is first asked a detailed question about their lifestyle and history in order to find out about possible hereditary factors, overloading, injuries or poor nutrition.
A physical examination is then carried out to determine hip mobility. Existing malpositions in the joint and swelling of the capsule can already be felt. With the help of targeted examination techniques, movement-dependent pain can also be determined in a targeted manner. Further information can be obtained via imaging examination methods. X-rays provide an informative representation of the hip joint in several planes.
The detection of changes in the joint space is a clear indication of cartilage abrasion. In addition, an ultrasound examination to support visualization of the soft tissues can be helpful in establishing the diagnosis. Magnetic resonance imaging or hip arthroscopy using a small camera probe provide specific, precise information about the distribution and vitality of the articular cartilage.
A blood test must be carried out to determine whether a bacterial infection could be the cause of hip arthrosis. If osteoarthritis of the hip causes initial pain, for example after getting up in the morning or after sitting for a long time, this pain and stiffness usually disappear after some movement.
If the disease is advanced, only shorter distances can be covered. A limp while walking may also occur. The pain occurs more and more frequently as pain from overexertion and ultimately also occurs at rest. As the wear and tear of the cartilage continues, complete hip stiffness finally occurs.
Complications
Osteoarthritis of the hip causes pain and restricts the patient’s movement. The quality of life is significantly reduced by the disease and everyday life is made more difficult for those affected. In most cases, certain activities or one’s own work can no longer be carried out. These limitations often lead to mental illness or depression.
Osteoarthritis of the hip causes pain, especially in the hips and joints. This pain can also spread to other regions of the body and thus lead to pain in the back, for example. It is not uncommon for patients to suffer from gait disorders and severe limitations in everyday life. Some of those affected need a walking aid or are dependent on other people in their everyday life if this is restricted by hip arthrosis.
Furthermore, the pain can also occur at night in the form of rest pain and lead to sleep problems. Osteoarthritis of the hip can be treated in various ways and the symptoms can be alleviated. There are no other complications. As a rule, the treatment is causal, so that patients who are overweight, for example, must first reduce their weight. Prostheses can also be used. Life expectancy is not reduced by this disease.
When should you go to the doctor?
If hip or joint pain is noticed that increases in intensity over time, osteoarthritis of the hip may be the underlying cause. A doctor should be consulted when symptoms first appear. If there are also gait disorders or other movement restrictions, a serious illness can be assumed, which must be clarified promptly. The person concerned should speak to their family doctor as soon as possible and consult an orthopedist for further clarification.
If pain occurs even with light physical exertion, a doctor must be consulted on the same day. Patients suffering from rheumatism, gout or osteoporosis are particularly susceptible to developing hip arthrosis. The same applies to people who have had a severe bacterial infection or who suffer from femoral head necrosis. Medications, lack of exercise and a generally unhealthy lifestyle are also possible triggers of the disease. Anyone who counts themselves among these risk groups should go to the doctor immediately with the symptoms mentioned. In case of doubt, the medical emergency service can be contacted first.
Treatment & Therapy
Osteoarthritis of the hip can be treated with joint-preserving therapy or joint replacement, depending on the patient’s findings. In the case of joint-preserving therapy, there should be a significant reduction in the previous cartilage abrasion. In addition, regeneration of the joint surfaces and cartilage cultivation should be achieved.
If the patient is significantly overweight, dieting and switching to a balanced diet is advisable in any case. In the case of one-sided, permanent overloading of the hip joint or insufficient movement, behavioral corrections must also be made. If the medication you are taking has caused the arthrosis, you must discontinue it. On the other hand, taking painkillers and anti-inflammatory drugs can be helpful and soothing.
Technical measures such as orthopedic shoes, crutches or bandages can also be advantageous for treating the disease by changing the load and deformity. Physical treatment measures such as heat or cold therapy and physiotherapy can also have a supportive effect. Injection therapy with hyaluronic acid can be promising for temporary relief of symptoms.
In an advanced stage of the disease, only surgical measures can help. Limited cartilage damage can often be repaired by hip arthroscopy. Broken pieces of cartilage are removed so that they cannot cause further abrasion. In addition, the roughened, torn cartilage is smoothed out. This leads to a calming of the synovial membrane and to the abatement of the hip complaints. In the case of more advanced joint destruction, a joint replacement with hip prostheses is performed as part of an operation. Cementless or cemented prostheses can be used.
Prevention
There are a number of things that can be done to prevent this from happening. Reducing body weight by five kilos in a severely overweight person can reduce the risk of osteoarthritis by almost 50 percent.
The diet should be high in green vegetables and low in red meat. Stimulants should be avoided entirely. A reasonable load on the hip joint at work and during sports as well as targeted gymnastic exercises or swimming are sensible preventive measures. Poor posture and overloading should be avoided. Typical movement restrictions and pain should be taken into account at an early stage and examined by a doctor.
Many people, especially in old age, suffer from osteoarthritis of the hip, which causes wear and tear on the cartilage layer. This leads to painful movement restrictions. If this development process cannot be stopped, only a joint replacement can help.
Aftercare
In the case of osteoarthritis of the hip, comprehensive medical treatment is required first. Follow-up care includes regular doctor visits. The responsible specialist will first examine the hip and have a conversation with the patient. This allows him to get an idea of how the disease is progressing and take further steps if necessary. Often the medication has to be adjusted or another operation has to be initiated.
Chronic diseases therefore require ongoing treatment. Individual symptoms such as initial pain or the typical joint and groin pain require comprehensive follow-up care. Persistent pain can be relieved with physiotherapy or simpler measures such as acupuncture and massage.
These practices mostly serve as a support when conservative treatment options have been exhausted. If a negative course of the disease with persistent walking difficulties and bad posture becomes apparent, appropriate preparations must be made. The patient needs aids such as crutches, it often happens that the profession has to be changed and changes in the household have to be made.
The responsible orthopaedist or family doctor takes over the follow-up care of hip arthrosis. After an operation, you should also consult the treating surgeon. In the beginning, a doctor should be consulted every two weeks. If he finds no complications, the appointments can be reduced to every month, then to every three months and finally to every six months.
You can do that yourself
In order to avoid additional pain or severe progression of the disease, overuse and overuse of the skeletal system should be avoided. Carrying or lifting heavy objects should be avoided. When it comes to footwear, make sure that it does not have high heels or is too tight. A rigid posture over a long period of time is also not good for your health. Balancing movements and correcting one-sided body positions are helpful in alleviating the discomfort. The hips, the pelvis and the back must be adequately protected against the effects of cold and draughts.
Those affected should observe and observe their own stress limit in the event of osteoarthritis. Sporting activities are to be aligned accordingly, but not stopped completely if possible. Body weight should be kept within the normal range. A healthy and balanced diet helps to strengthen the skeleton and stabilize the immune system. For activities while sitting, an ergonomic sitting position must be ensured. At the same time, sleep hygiene must be optimized for a balanced night’s sleep. The body needs sufficient rest and recovery phases, which should be firmly integrated into everyday life.
The skeletal system can be supported and the symptoms alleviated with selected physiotherapy exercises. The training units are to be carried out regularly and according to specifications by trained personnel.