Joint pain in the hips is commonly caused by arthritis, but the type of arthritis causing the pain can vary. Within the 100 different types of arthritis, osteoarthritis and inflammatory arthritis are both known to cause hip pain, but their causes and who it affects differ greatly. Osteoarthritis of the hip is a result of “wear-and-tear” and damage to the joint’s cartilage over time. It is found to affect people later in life, whereas inflammatory arthritis can affect people of all ages with signs often starting to show in early adulthood. Inflammatory arthritis is a result of an overactive immune system causing the body to attack healthy tissues. While the causes of inflammatory arthritis are unknown, evidence has shown there to be a link between genetics and the role it plays in the development of this disease.
Those with inflammatory arthritis in their hip will most often be diagnosed with one of the following three types of arthritis:
- Rheumatoid Arthritis: This autoimmune disease causes a chemical substance to be produced that will attack and destroy the articular cartilage covering the bone.
- Ankylosing spondylitis: Causing chronic inflammation of the spine, this arthritis can result in lower back pain and stiffness, and can affect other joints including the hip.
- Systemic lupus erythematosus: Occurring mostly in young adult women, this type of arthritis can cause a higher incidence of osteonecrosis of the hip, a disease that causes bone cells to die, weaken bone structure, and lead to disabling arthritis.
Symptoms of Hip Arthritis
Symptoms of inflammatory arthritis in the hip often manifest as pain, stiffness, and discomfort in various regions, including the groin, outer thigh, knee, or buttocks. Individuals may experience a dull, aching sensation exacerbated by movement, potentially leading to difficulties in walking and a discernible limp. While activity can alleviate symptoms to some extent, excessive exertion may exacerbate the condition, necessitating prompt intervention for effective management.
Nonsurgical Treatment for Hip Arthritis
Inflammatory arthritis of the hip can interfere with a person’s every-day activities and their overall quality of life. While there is no cure for this disease, there are both nonsurgical and surgical treatment options that may help prevent joint destruction. The sooner treatment is started, the greater chance there is of preserving the hip joint.
The treatment type chosen depends heavily on the type of inflammatory disease being treated and the health professional providing the care. Nonsurgical treatment options can sometimes include a combination of various methods including:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroids
- Disease-modifying antirheumatic drugs (DMARDs)
- Physical therapy
- Assistive devices (cane, walker, long-handled shoehorn, etc)
Surgical Treatment for Hip Arthritis
If a patient is a candidate to treat their inflammatory arthritis with surgery, generally the two surgical options include total hip replacement and synovectomy.
- Total Hip Replacement: This surgical procedure entails the removal of damaged joint surfaces, which are then replaced with prosthetic implants designed to replicate the natural hip joint. Composed of durable materials such as metal, polyethylene, and ceramic, these implants restore smooth joint movement and alleviate pain.
- Synovectomy: Synovectomy involves the partial or complete removal of the inflamed joint lining (synovium), particularly beneficial in the early stages of inflammatory arthritis. By addressing synovial inflammation, this procedure aims to mitigate further damage to the articular cartilage, preserving joint function and integrity.
In this brief video, orthopedic surgeon Dr. James Hall provides insights into outpatient hip replacement surgery, highlighting its benefits and risks.
If the disease has progressed far enough that surgery is the only option, total hip replacement has shown to be one of the most successful operations in all of medicine. The type of surgery a surgeon chooses depends on age, condition of the hip joint, the specific disease causing inflammatory arthritis, and the progression of the disease. Both surgical treatment options have been shown to help improve function, increase motion, and relieve pain.
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