Hip osteoarthritis - Dr. Michael Lehmann

What is hip osteoarthritis?

Hip osteoarthritis is the term used to refer to all degenerative diseases in the area of the hip joint and especially occurs later in life. Normally, a smooth lining of cartilage over the joints ensures friction-free movements. With osteoarthritis, this articular cartilage exhibits widespread damage and in some cases can be completely destroyed.

Typical causes of hip osteoarthritis include many years of excessive or unequal strain on the joint, falls onto the hip or ageing processes in the cartilage that can occur as a result of constitutional characteristics.

The most common cause of hip osteoarthritis is cam impingement. This means that there is unwanted contact between the neck of the femur and the joint cartilage in the socket due to deformity of the femoral head and femoral neck contours. If the impingement or cartilage injury is not resolved, consequential damage such as osteoarthritis is inevitable.

Symptoms of hip osteoarthritis

To begin with, sufferers experience mild pain on stressing the hip, with stiffness in the joint or the groin area. Pain is also felt when initiating movement, as well as pain on stressing the joint. The pain can rapidly progress and lead to restricted movement. Pain at rest and increasingly restricted movement are symptoms of progressive osteoarthritis.

Important: pain from osteoarthritis should always be taken seriously and under no circumstances should it be prematurely accepted as unchangeable. In many cases, carefully planned treatment can achieved considerable successes.

Treatment for hip osteoarthritis

If conservative treatment options for hip osteoarthritis have already been exhausted, surgical intervention must be carried out. A distinction is made between conservative arthroscopic methods and in more severe cases the implantation of an artificial hip joint (hip prosthesis).

Depending on the degree of osteoarthritis, joint debridement (tidying-up of the joint) may provide significant relief. In this process, mobile parts of the cartilage are smoothed out, the joint capsule that is distorted and contracted due to severe inflammation is removed and bony spurs are taken away. Subsequent flushing of the joint with fluid also removes any tiny particles of worn tissue that would otherwise act like sand in the joint and can increase friction inside it.

To stimulate the formation of new cartilage, an abrasion arthroplasty can be beneficial for smaller defects. With this method, the cartilage is ground down to the vascularised bony layer. A blood clot then forms at the site containing stem cells. Within a few weeks, these stem cells form cartilage fibres that are able to fill in the defect.

A similar procedure is micro-fracturing, which also causes stem cells to enter the joint. However unlike the abrasion arthroplasty, drill holes are used that can also be used for larger cartilage defects.