What Is Osteoarthritis of the Hip?
Osteoarthritis of the hip is a condition that gradually worsens over time. Many patients over the age of 50 develop osteoarthritis with symptoms. Because the hip joint is a primary loadbearing joint, evidence of early osteoarthritis presents with a limp. As the Cartilage gradually erodes there is bone-on-bone contact causing worsening of pain and arthritis. At this point, a complete or partial hip replacement may be advised. Factors that are known to worsen osteoarthritis include age greater than 50, a genetic or family history, obesity, congenital deformities often at birth, a history of trauma, or a family history of other diseases that can cause arthritis and other joints. The symptoms often present with pain with walking, often with radiation into the groin or the front of the thigh or even down to the knee.
The pain is often worsened with activity such as walking and running, early morning stiffness or AO sticking of the joint, and a decreased range of motion. The patient often described worsening conditions with cold and wet weather. Diagnosis of osteoarthritis involves a thorough history and physical, including past medical history and any bloodwork if required. Imaging studies such as x-rays, MRIs and CAT scans, and even electrodiagnostic studies in certain cases can help with the diagnosis. Osteoarthritis of the hip treatment is multifactorial. The goal of treatment is to eliminate causes of worsening arthritis when possible, followed by image-guided injections of steroid, PRP, or even disco supplementation, and more recently amniotic fluid.
Physical therapy early on can be very effective. Treatment options include analgesics for temporary pain relief, low-dose antidepressants which are helpful in both sleep and chronic pain, non-steroidal medications. Physical therapy includes home exercises to help strengthen and improve the flexibility and range of motion of the joint and associated muscles. Diagnostic / Therapeutic joint injections with steroids as well as injections PRP ( platelets rich plasma) may also be effective and augment the effects of oral medication and physical therapy. Surgeries are reserved for when the above treatments are ineffective or inadequate.
Treatment options for current condition
- Conservative Treatment
- Physical Therapy
- Anti-inflammatory Medications
- Surgical Treatment
- Total hip Replacement
- Interventional Pain Management
- Fluoroscopy Guided Intraarticular Hip Joint Injection
- Treatment with Platelet Rich Plasma (PRP)
Before and After the Procedure and the Risks
Before the Procedure
You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over-the-counter medications you take, including herbal and vitamin supplements. In particular, you should temporarily stop taking for at least 10 days before the procedure date, any medication that can cause unnecessary bleeding: Aspirin, Vitamin E, arthritis medications like Advil, Ibuprofen and blood thinners like Coumadin, Plavix, Trental, etc. The doctor will tell you if and when you need to discontinue the medications.
It is very important to tell the doctor if you have asthma, had an allergic reaction (i.e. hives, itchiness, difficulty breathing, any treatment which required hospitalization) to any local anesthetic agent used in the past, such as novocaine or lidocaine. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.
After the Procedure
Icing for 15 to 20 minutes several times later on the day of the injection is recommended, along with easy range of motion exercises of the joint. You may return immediately to work or regular activities after the injection. You may drive, although some people feel less nervous if they know they have someone along to drive them home. You should continue any physical therapy sessions already scheduled. You may be sore over the treated areas for the first 24 to 48 hours. If any unusual redness or swelling or warmth occurs at the injection site, notify the physician. You may continue taking all of your regular medications. It may take a few days for the corticosteroid medication to start working and you should notice long-term pain relief starting to work by then.
The risks, although infrequent, include: Allergic reaction to the medications used; Nerve damage; Bruising or infection at the injection site. If you experience persistent pain or numbness in the area of the injection site after the normal healing period (usually 3-5 days), you should call the doctor right away.