WHAT IS ARTHRITIS OF THE HIP?
Arthritis of the hip is a disease which wears away the cartilage between the femoral head, or hip ball, and the acetabulum, or hip socket, causing the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded and uneven. The result is pain, stiffness and instability, and in some cases, motion of the leg may be greatly restricted.
Osteoarthritis, which is the most common form of arthritis in the United States, is degenerative and, although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.
It is usually confined to the large weight-bearing joints of the lower extremities, including the hips and knees, but may affect the spine and upper extremity joints, too. Patients with osteoarthritis often develop large bone spurs, or osteophytes, around the joint, further limiting motion.
Unlike osteoarthritis, which is a "wear and tear" phenomenon, rheumatoid arthritis is a chronic inflammatory disease that results in joint pain, stiffness and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.
Hip Surgery – Know Your Options
NON-SURGICAL OPTIONS FOR HIP PAIN
Hip pain doesn't necessarily mean hip surgery. There are many options for you to discuss with your doctor to alleviate hip pain.
Exercise and Weight Control - Research shows that exercise is one of the best treatments for osteoarthritis. Exercise may help decrease pain, improve flexibility and maintain weight. A healthy diet can facilitate weight loss resulting in reduced stress on weight-bearing joints and limiting further injury.
Physical Therapy - Your doctor may prescribe physical therapy as a course of treatment. It is important for you to work with your physical therapist and learn proper technique of your exercises. These exercises are specifically designed for your condition and may prove effective in building supporting muscles and loosening stiff muscles that cause pain.
Medication - Heat and Cold are non-drug ways that may relieve pain. A warm bath, hot packs or cold packs are simple techniques that may help with pain. Medicines commonly used in treating osteoarthritis include: acetaminophen, NSAIDs (nonsteroidal anti-inflammatory drugs), topical pain-relieving creams and sprays, narcotic painkillers , corticosteroids, and hyaluronic acid. Many medicines used to treat OA have side effects, so it is important for patients to learn about the medicines they take. Consult your doctor before using medications for pain relief.
Injections - Steroid injections may provide relief from hip pain. Your doctor will advise you on the efficacy of this treatment and monitor how effective this course of treatment is for you.
There are many other options promoted for relief of pain, and while some may be effective, others could be potentially harmful. Always consult your doctor before embarking on any course of care to ensure you will get the maximum benefit for your condition.
What is Total Hip Replacement?
IS TOTAL HIP REPLACEMENT SURGERY FOR YOU?
The good news is that if you are considering total hip replacement surgery, you're not alone. According to the hospital billing data, each year more than 340,000 such procedures are performed in the US.1 Even better news is that the US Department of Health and Human services considers total hip replacement to be one of the most successful and cost effective interventions in medicine.1 In fact, the success rate for hip replacements 10 years after surgery is 90-95%.1
Of course, the decision to have hip replacement surgery should be a cooperative one made by you, your family, your primary care doctor, and your orthopaedic surgeon. The process of making this decision typically begins with a referral by your primary care doctor to an orthopaedic surgeon for an initial evaluation.
How is Hip Surgery Performed?
During hip replacement surgery, the surgeon surgically removes the damaged bone and cartilage of the joint and replaces it with smooth, artificial implants - thereby eliminating painful bone-on-bone contact.
Almost all hip replacement implants consist of a four-part system:
- A hip stem, usually made from a biocompatible metal such as titanium, which is implanted down the shaft of the thigh bone (femur);
- A femoral head which sits on top of the hip stem and replaces the "ball" portion of the hip's "ball and socket" design; and
- A two-part hemispherical or "cup-like" component made up of a metal shell and a plastic liner that replaces the "socket" in which the femoral head sits.
- Once implanted, the new femoral head rotates inside the plastic liner to recreate the ball and socket movement of the original joint.
When is Hip Surgery Recommended?
HOW DO I KNOW WHEN IT'S TIME TO CONSIDER SURGERY?
There are several reasons why your doctor may recommend hip replacement surgery. People who benefit from hip replacement surgery often have:
- Hip pain that limits everyday activities, such as walking or bending
- Hip pain that continues while resting, either day or night
- Stiffness in a hip that limits the ability to move or lift the leg
- Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports.
IMPORTANT SAFETY NOTES:
Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.
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