Osteoarthritis of the hip

Synonyms

Coxarthrosis, hip joint arthrosis, hip arthrosis

definition

Osteoarthritis of the hip is irreversible, progressive destruction of the hip joint.
This usually occurs as a result of an incorrectly placed acetabulum or a head that is not ideally suited to the acetabulum.

introduction

The bony hip joint is a large, central joint, which consists of the joint head (thigh bone (femur)) and the joint socket (acetabulum).
It is involved in every change of position (sitting, standing, lying), which can lead to significant restrictions in everyday life for the affected patient with osteoarthritis of the hip.

14% of the population show signs of hip arthrosis on X-rays, of which only 5% suffer from symptoms.
Osteoarthritis in the hip is one of the rare forms of osteoarthritis. 35% of the time it occurs on both sides.

Symptoms

The onset of the disease is usually insidious with little pain on exertion. In the course of the disease, there are referred pain in the groin, thigh, buttocks or even down to the knee.

Start-up pain typically occurs in the morning after getting up and after sitting for a long time. These symptoms improve during the day, but increase again in the evening.

Furthermore, the patients complain of rapid fatigue and a feeling of stiffness as further symptoms.

With advanced arthritic changes in the hip, there is more frequent inflammation of the joint skin (synovitis), which cause permanent pain independent of exercise and mask typical symptoms such as start-up pain.

Read more on the topic: Symptoms of hip osteoarthritis

Appointment with a hip expert?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

causes

It applies between one primary and one secondary osteoarthritis to distinguish. While the cause of primary osteoarthritis remains unknown, secondary osteoarthritis is another disease hip osteoarthritis prefixed.

For example, a congenital cause of secondary osteoarthritis of the hip is Hip dysplasiawhich was not treated or treated unsuccessfully. Circulatory disorders of the femoral head (Femoral head necrosis, Perthes disease) and solutions of the growth plate on the femoral head (Epiphyseal capitis femoris) often lead to osteoarthritis of the hip.
Misalignments of the leg axis, inflammation or injuries to the hip joint are other special causes Coxarthrosis.

diagnosis

Due to the variety of symptoms, the diagnosis is made using a physical one Investigations and X-rays posed.

A inhibition at the Spreading as well as the Internal rotation (i.e. turning inwards) the thighbone in the hip can next to one Stretch deficit Be signs of osteoarthritis in the hip joint.

Typical signs of osteoarthritis such as the Joint space narrowing or bony attachments (so-called osteophytes) to be expected.
If pain in the hip is unclear, osteoarthritis changes in the lumbar spine can also be the cause of the symptoms. By injecting a Local anesthetic in the joint space of the hip, in this case it can be determined where the pain is coming from.

Therapy of osteoarthritis in the hip

Since it is not possible to restore the defective cartilage and bone, the therapy primarily focuses on reducing pain and slowing down the course of the disease.

Conservative therapies include wearing:

• soft footwear (gel cushions / buffer heels)
• Weight reduction
• Appropriate diet for osteoarthritis
• Exercise that is gentle on the joints (cycling, swimming)
  Please also read: Sport for hip osteoarthritis
  such as
• Physiotherapy to correct muscle breakdown (muscle atrophy) due to improper stress and the like.

If the pain relief under medication such as ibuprofen, metamizole or Voltaren® is not sufficient, a therapy attempt with injections of local anesthetic (short-term) or cortisone (long-term) into the joint space of the hip can be attempted.

If there is a high level of suffering and if conservative therapy attempts have failed, surgery on the hip can be considered if the conditions are right.

Read more on the topic: Surgery for hip osteoarthritis

Up to the age of 60 and depending on the cause, joint-preserving surgery is possible for moderate to moderate osteoarthritis. The thigh bone is deformed in such a way that the pressure of the femoral head is better distributed in the acetabulum and the mechanics are reconstructed.

A subsequent joint replacement therapy using a hip prosthesis should be taken into account in the joint-preserving therapy.

For patients over 60 years of age, endoprosthetics using a hip prosthesis is a frequently necessary therapy. A wide range of models, sizes and combinations of acetabular and femoral head replacements are available, so that this therapy requires more precise individual planning.

Following such an operation, the cooperation of the patient is particularly important for the success of the therapy.

Read more about this: Treatment of hip arthrosis

Illustration of the hip joint

1. Acetabulum - Acetabulum
2. Iliac scoop - Ala ossis ilii
3. Iliac crest - Iliac crest
4. Articular lip of the acetabulum -
   Labrum acetabuli
5. Femoral head (= Thigh head) -
   Head femoris
6. Femoral neck - Collum femoris
7. Great Rolling Hill -
   Greater trochanter
8. Femoral shaft -
   Corpus femoris
9. Small rolling hill -
   Lesser trochanter
10. Ischium - ischium
11. Hip hole - Obturate foramen
12. Pubic bone - Pubis
13. Lumbar and sacrum kink - Promontory
    
    To Hip bone three bones fuse together: the iliac, pubic and ischium

You can find an overview of all Dr-Gumpert images at: medical illustrations

Prognosis and prophylaxis

Depending on the cause, there are certain prophylaxis options:
For example that Screening by means of Ultrasonic of newborns to one Hip dysplasia and the associated early therapy.

Excursus: Asians and black Africans are less likely to get one Coxarthrosis, which is partly attributed to a certain swaddling and transport technique used by babies, in which the position of the head of the thigh is unconsciously favored that a congenital hip dysplasia is treated immediately. This prevents osteoarthritis in the hip.

A body weight in the normal range and exercise that is gentle on the joints can reduce the risk of osteoarthritis in the hip, but not prevent it from developing.

If osteoarthritis of the hip is known, it cannot be cured. Satisfactory freedom from symptoms can generally be achieved with the therapy options mentioned above, but not always.

Even with a perfect implanted hip prosthesis the function of the joint will not correspond to that of the healthy joint. The patient should be aware of this before an operation. Nevertheless, a very productive life is possible again with a hip prosthesis.