Arthritis
What is Arthritis?
Cartilage is a smooth, supportive tissue found throughout the body, particularly in the joints. It allows bones to move easily against one another while cushioning and stabilizing the joint. When cartilage becomes damaged or inflamed, it can lead to arthritis over time.
There are several types of arthritis that can affect the hip joint. The most common is osteoarthritis, which develops from gradual wear and tear of the joint. This causes deterioration of cartilage and surrounding structures. Inflammatory arthritis, on the other hand, results from autoimmune conditions such as rheumatoid arthritis or lupus, in which the immune system attacks the joint, leading to inflammation and damage.
In advanced cases of arthritis, the cartilage may wear away completely, allowing the bones of the hip joint—the femur and pelvis—to rub directly against each other. This bone-on-bone contact causes significant pain, stiffness, and inflammation.
Causes
The exact cause of osteoarthritis remains unclear, though it is commonly linked to chronic wear and tear over time. Age is a major factor, as cartilage naturally deteriorates with use. However, younger individuals may also develop osteoarthritis due to injury, joint shape abnormalities, or other biomechanical factors.
Rheumatoid arthritis, unlike osteoarthritis, is believed to be related to genetic and immune system factors. Those with a family history of autoimmune diseases may be more likely to develop this type of arthritis.
Symptoms
Symptoms of arthritis in the hip include:
- Deep or aching hip pain
- Stiffness or reduced range of motion
- Difficulty walking or performing daily activities
Diagnosis
Diagnosis of hip arthritis involves a combination of a detailed medical history, physical examination, and imaging studies.
- Radiographs (X-rays): Used to identify joint space narrowing, bone spurs, or structural abnormalities.
- Physical examination: Assesses range of motion, pain with specific maneuvers, and joint stability.
- Medical history: Includes review of prior injuries, surgeries, and progression of symptoms.
Treatment Options
Treatment depends on the severity of arthritis, the patient's lifestyle, and overall health. In many cases, non-surgical treatments can help manage symptoms and improve function.
- Activity Modification and Rest: Reducing high-impact activities may help relieve discomfort.
- Physical Therapy: Strengthens the surrounding muscles and improves joint mobility.
- Medications: Anti-inflammatory drugs can decrease pain and swelling.
If conservative measures fail to provide relief, surgery may be recommended to restore joint function and alleviate pain.
Surgical Options
Hip Replacement
A total hip replacement involves removing the damaged cartilage and bone, and replacing them with a metal cup in the socket and a metal stem in the femur. A durable plastic liner is placed between these components to allow smooth, pain-free motion. This procedure can be performed through either an anterior or posterior approach. Dr. Benjamin Domb and his team may also use robotic guidance to improve accuracy in implant positioning and outcomes.
Hip Resurfacing
Hip resurfacing preserves more of the patient's natural bone by capping the femoral head with a smooth metal surface and placing a metal cup in the socket. This procedure is often recommended for younger, more active patients who wish to maintain higher activity levels. Like total hip replacement, it can be performed through either an anterior or posterior approach.
