What is degenerative osteoarthritis of the hip?

• Osteoarthritis or degenerative osteoarthritis is a disease that can affect one or more joints in the human body.
• Degenerative osteoarthritis of the hip is the one that affects the joint we know as the hip, obviously, although the pain can extend to other parts of the body, such as the knees, thighs, buttocks, etc.
• The most effective solution to correct severe degenerative osteoarthritis of the hip is the fitting of a total prosthesis to replace the affected joint.

Cartilage is the tissue that covers the bones that make up the joints, which, together with a fluid called synovial fluid, serves to prevent the wear and tear of our bones due to friction when walking or performing other types of physical activities.

When the synovial fluid begins to thicken and the cartilage begins to wear down for various reasons, such as age or overuse of the joint, friction between the bones increases, which will lead to pain, deformation of the hip and eventually immobility.

The wear and tear of the cartilage covering the hip bones, which can be due to multiple factors, is known as degenerative osteoarthritis, something that mainly affects older adults.

Degenerative osteoarthritis of the hip can be classified into two types depending on what causes it:

• Primary degenerative osteoarthritis of the hip: There are no specific causes, however, there are risk factors that can cause it, such as aging. This type of degenerative osteoarthritis of the hip is the most common, especially in people over 65 years of age.
• Secondary degenerative hip osteoarthritis: In these cases, degenerative hip osteoarthritis is due to specific causes, and can also affect younger people, such as genetic malformations at birth that involve incongruence between the femur and the hip socket.

The main risk factors that can cause degenerative osteoarthritis of the hip are:

• Ageing: This is the factor most directly related to degenerative osteoarthritis of the hip because, as people get older, they undergo changes in their cartilage. It affects women to a greater extent.
• Obesity: The heavier a person is, the more weight the hip joints have to bear and the more wear and tear the cartilage suffers.
• High-level sport, with the resulting load on the joint.
• Work that requires physical strength, also with the resulting load on the joint.

Other causes that can lead to the onset of degenerative osteoarthritis of the hip are:

• Genetics: People whose direct relatives have suffered from degenerative osteoarthritis are more likely to suffer from it.
• Trauma: Due to poorly healed injuries, previous fractures or other types of alterations.
• Malformations of the hip: Although there are no studies that prove it 100%, it has been shown that a slight incongruence between the femur and the hip socket of the pelvis causes degenerative osteoarthritis of the hip at an earlier age and with greater severity.
• Hormonal factors: Degenerative osteoarthritis of the hip can also appear in women after the menopause due to the hormonal changes associated with this stage of life.

The most obvious symptom of degenerative osteoarthritis of the hip is pain. It usually appears in the front part of the thigh, and can go as far as the knee, not in what is normally known as the hip.

Most commonly, the pain appears in the morning when the patient starts walking, but usually disappears when the joint starts to move. When a considerable distance has been walked, the pain reappears, which may disappear again with rest. In any case, this symptom is only in the main stages of the disease, as in the most severe cases the pain is permanent and even prevents the affected person from sleeping.

Loss of mobility due to degenerative osteoarthritis of the hip: this is due to pain, as the patient tends to move the hip less and to reduce effort, as well as the deformation that the joint may suffer due to wear and tear.

Degenerative osteoarthritis of the hip can be treated in three different ways:

Non-pharmacological treatment of degenerative osteoarthritis of the hip

In these cases, the aim is to make a change in the patient's lifestyle to reduce the friction and overload on the joint. These changes include:

• Weight loss: The heavier a patient is, the more pressure the joint suffers, accelerating the progression of osteoarthritis and increasing pain.
• Aerobic exercise: To avoid overstraining the joint with some sports, it is advisable to focus on exercises such as swimming or cycling to strengthen the muscles adjacent to the hip and minimise the load on the joint.

Pharmacological treatment of degenerative osteoarthritis of the hip

The specialist may recommend that the patient take medication to reduce inflammation, if any, or to reduce pain in the joint. These medications will usually be analgesics and anti-inflammatory drugs. In slightly more severe cases, infiltration with more aggressive analgesics and even hyaluronic acid may be performed.

Surgical treatment for degenerative osteoarthritis of the hip

When osteoarthritis of the hip is in an advanced stage and prevents the patient from leading a normal life, due to pain, loss of mobility and, in short, loss of quality of life, the most advisable option is a hip replacement operation.

This operation eliminates the pain and corrects the deformity suffered by the joint, considerably improving the patient's quality of life.

Despite the good results of the operation, it is important to carry out intensive rehabilitation in order to recover maximum mobility and elasticity.