Traumatologists define osteoarthritis as a degenerative process occurring in articular cartilage, the part covering the bone ends which together result in the joints, causing wear.

In the case of hip osteoarthritis, the cartilage covering the hip joint, consisting of a hemispherical cavity (acetabulum of the pelvis) and a ball which is articulated in it (femoral head) becomes worn. This cartilage is essential for the proper functioning of the hip because it is the surface that absorbs loads and allows the movement of a joint.

Over the years, the cartilage ages and becomes softer and fragile. On its surface cracks and erosions appears which leave the bone uncovered. As a result the hip joint with osteoarthritis becomes irregular and thus limiting mobility, causing pain and disability.

Hip osteoarthritis can be:

  • Primary. It is caused by use and aging. It may appear from 60 years and there are predisposing factors, genetic, form of the femoral head, overuse, professional impact sports etc.
    Secondary. It is caused by rheumatic and metabolic diseases; congenital hip dislocation and dysplasia; sequelae of trauma; vascular diseases of the femoral head.

How does hip osteoarthritis manifests itself?

A patient finds out he or she has hip osteoarthritis beginning with the sensation of pain, decreased mobility, and limping. The pain of hip osteoarthritis is characterized by:

  • Pain when you start walking: after the first steps the pain usually subsides and you can walk a while, but later it starts again, obligating the patient to rest. A period of rest usually improves it.
  • The pain is usually located in the area of the groin and upper thigh. It can even reach the knee.
  • Decreased joint mobility: Initially it is presented as stiffness when you begin walking, which improves with moving.
  • Produces limited of range of motion, making the activities of ordinary life more difficult, like cutting toenails, putting on socks or stockings, sitting on the couch, going up or down the stairs, into the bath tub, difficulty crossing your legs.
  • Limping begins as mild or unapparent and with time becomes more obvious due to pain, muscle atrophy and joint stiffness.

What factors predispose a hip osteoarthritis?

Osteoarthritis is a degenerative process in direct relationship with age. Primary osteoarthritis usually occurs from 60-65 years. Secondary osteoarthritis can occur at any age because the cause is not only traumatic degenerative, rheumatic, vascular, congenital dislocation or dysplasia.

Besides age, other factors influence the development of hip osteoarthritis:

  • Family history, since osteoarthritis is hereditary,
  • Obesity, overweight causes the overload of our joints and can damage the cartilage.
  • Activity, work involving an overload or continued impact on our hips also predispose to hip osteoarthritis.
  • Some diseases, such as rheumatoid arthritis or congenital malformations or trauma hip fracture or hip may also predispose to the disease.

What is the initial treatment for hip osteoarthritis?

There are various forms of treatment. In the first place it is advisable to get rid of overweight, lose weight contributes significantly to reduce pain in hip osteoarthritis. It is also desirable to perform gentle exercises that help maintain mobility and prevent atrophy of the hip muscles. In the initial stages some anti-inflammatory drugs or physical therapy may also help, however, with the pass of time these measures are no longer effective and disability is getting worse and this is when the possibility for a hip replacement operation arises.

When should a hip prosthesis be placed?

The placement of a hip prosthesis is recommended when the joint suffers an advanced wear and other treatments have already been tried without success. The surgical procedure involves removing the damaged parts of the joint and replacing them with implants.

These hip implants consist of a hemispherical acetabulum to replace the acetabulum of the pelvis and a stem which is inserted into the femur to which a spherical head is connected. These implant materials are compatible with our tissues (polyethylene, ceramics or metals such as titanium or chrome cobalt ).

There are prosthesis types which are fixed to bone with the help of special acrylic cement and other type which is fixed without cement and they require adjustment, a perfect fit to the bone. These implants have a rough surface and micropores through which the bone grows, thus those implants are fixed or are integrated in a practically biological way to the bone surface. Generally prostheses are cemented to the bone in the elderly or people with weak bones and placed without cement on those who have stronger and younger bones.

What is the lifespan of the prosthesis?

Hip replacements have a limited lifespan which vary from one person to another. With the new materials the lifespan can be considerably extended to approximately 12 to 15 years or more.