Hip Arthritis: Treatment Options

Hip Arthritis: Treatment Options

Since the surface cartilage in a joint cannot grow back and heal on its own like a cut on the skin can, osteoarthritis in any joint can only get worse over time. It is just a matter of how quickly it happens. If left untreated, pain from hip arthritis will continue to increase, and simple movements will become more and more difficult. Eventually, a cane or walker might be needed in order to walk just a short distance around the house.

A patient with mild or moderate arthritis might benefit from nonoperative treatment. The American Academy of Orthopaedic Surgeons supports the use of non-narcotic medications like anti-inflammatory medication or acetaminophen, corticosteroid injections, and physical therapy to help improve pain and function. Avoiding high impact activities can help as well. Someone who has pain with running might change their exercise to swimming or biking. The patient should discuss these with their doctor.

As long as nonoperative treatments are helping, patients can continue to do the activities that they tolerate. If the pain is getting worse and daily tasks are becoming more and more difficult despite nonoperative treatment, then surgery may be the next option.

Even though it is less invasive, hip arthroscopy using a small camera and small instruments, has not shown to provide long-term relief for hip arthritis. It may help for a few months, but most patients end up getting the definitive surgical treatment for hip arthritis, a hip replacement.

Hip replacement surgery, also known as total hip arthroplasty, is a procedure that removes the damaged cartilage in the joint and replaces the socket with a metal cup and the ball with a metal ball and stem. There is a plastic liner placed between them so metal is not rubbing on metal. In some cases, the surgeon may choose to use a ball made of ceramic instead.

Patients should have a thorough discussion with their surgeon to make sure that hip replacement surgery is right for them. A hip replacement is considered an open surgery where the procedure is done through a single incision. Depending on the surgeon's preference, the incision can be in different locations around the hip.

Some surgeons choose to do a direct anterior approach. The patient will be lying on their back and the incision would be made directly over the front of the hip. Other surgeons will have the patient lying on their side and make the incision in one of several other locations.

No matter where the incision is, the steps of the procedure are pretty much the same. The damaged cartilage is taken out by removing the ball and smoothing out the socket. A metal stem is put down the shaft of the thigh bone and a new ball is placed on top. A metal cup is put in the socket, held in place with screws, and a plastic liner is inserted between the ball and the socket.

Bone slowly grows and attaches to the metal stem and socket over time, and the hip joint can move freely without rough surfaces causing friction. Instructions for the patient after surgery are designed to help reduce the pain from surgery, help prevent infection of the incision, and encourage some movement of the hip to keep it from getting stiff.

However, too much movement too soon can cause complications. It is also common for patients to require a walker until their pain has gone down and they are strong enough to walk on their own. It is important for a patient to know what is involved in the recovery process so they know what to expect.

Some patients may take only 2-3 months to recover from a hip replacement, while others a bit longer, but they all have the same goal, returning to their normal daily activities with minimal to no pain.