Arthritis of hip means destruction of the hip joint due to damage to the cartilage, which exposes the underlying bone. Progressive destruction of the joint leads to wearing off of the bone. This causes changes like osteophyte formation (bone spurs at the edge of the joint) and synovitis (thickening of joint cover).
The adjoining figure shows a femoral head (ball) with arthritic changes. This was removed from a patient with rheumatoid arthritis.
The patient has pain in the hip, which can be felt in the groin, and may also radiate to the buttocks, thigh and knee. Pain is felt at rest; and also during any activity which involves movement in the hip joint, such as walking, sitting cross-legged, climbing up or down the stairs, and getting up from sitting position. In severe arthritis the patient is severely disabled with pain. In some cases there is shortening of the leg and internal or external rotation deformity.
A thorough clinical examination is followed by a set of blood tests, X-Rays and other investigations. The changes seen on the X-Ray in an arthritic hip are:
Patients with mild to moderate hip arthritis can be usually treated with painkillers, physiotherapy, weight reduction and lifestyle modifications.
However, in severe arthritis, medications will relieve pain only for a short duration, while their prolonged use will be harmful to the stomach, liver and kidneys. In such cases, one may consider total hip replacement (THR) surgery as an effective and permanent solution. THR can relieve pain and restore the patient to near-normal level of daily activities.
