How does a joint work?
In a normal joint the end of the bone is covered by a layer of cartilage which is very strong and very smooth. The joint is lubricated by synovial fluid and the combination of cartilage and the lubricating fluid allows the joint to move with minimal friction which allows smooth pain free motion over a long period of time.
What is Arthritis?
Arthritis is basically a painful joint.
Arthritis is long term damage to the surfaces of a joint, causing pain and stiffness. The commonest type of arthritis is osteoarthritis, often referred to as ‘wear and tear’ arthritis. We don’t fully understand how or why osteoarthritis occurs. It is largely genetic (inherited and runs in families), and is also influenced by injuries, being overweight, and severe overuse in sport or work. Other forms of hip arthritis include rheumatoid arthritis, and arthritis that develops as a result of childhood hip problems like hip dysplasia.
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What are the symptoms of hip arthritis?
The commonest problems are pain, stiffness and a limp. Pain is most commonly felt in the groin, but may also be on the side of the hip, buttock, the thigh and the knee (occasionally knee pain is the only sign of hip arthritis). The pain is often constant, with and without activity, and present at night as well as during the day. Stiffness makes it difficult to get to your feet, put shoes and socks on, pick things up off the ground, get into and out of low chairs and cars.
What are other causes of hip pain?
Other causes of pain around the hip include, but are not limited to:
- Tendon tears and muscle weakness – gluteal tendons on the side, adductor tendons in the groin, hamstring tendon in the buttock.
- Back problems – particularly if it is in the buttock and down the back of the thigh, or continues down below the knee.
- Labrum tears and hip impingement
- Hernia or abdominal problems
- Stress fracture or osteoporosis in the hip
What is the best scan for hip arthritis?
A plain x-ray of the hip is very good at detecting hip arthritis. It is unusual to need CT or Ultrasound or MRI.
How do you treat arthritis?
We can’t cure arthritis, so the aim of treatment is to relieve the pain and stiffness. Weight loss and strengthening exercises, simple pain killers such as paracetamol (Panadol, Panamax etc.) and anti inflammatories (ibuprofen, Celebrex etc.) can all help. Injections such as cortisone, PRP, orthokine and stem cells can help the pain temporarily, but they don’t regrow the damaged hip cartilage. They can be useful if you have a particular event or trip that the hip would stop you from doing otherwise.
Hip arthroscopy is not as reliable once there is arthritis in the joint. It may help pain for a couple of years but it will not change the gradual progression of the arthritis.
Hip replacement is a very effective way of permanently getting rid of the pain and stiffness caused by hip arthritis. If painkillers, exercise and weight loss are not adequately relieving the pain then it is the best option for long term pain relief.