Arthritis of the hip

Arthritis of the hip is a condition that causes the hip joint and surrounding connective tissue to be inflamed, causing pain, swelling and limited movement of the hip. Arthritis is just one of more than 100 types of rheumatic diseases (diseases that affect joints and connective tissues). Depending on the type of hip arthritis, symptoms can range from pain and swelling in the joints to difficulty using or moving the joint in a normal way.

You may experience one or more of these common symptoms of arthritis of the hip:

• Pain and stiffness in the joints
• Swelling in one or more joints
• Continuing or recurring pain or tenderness in a joint
• Difficulty using or moving a joint in a normal manner
• Warmth and redness in a joint
• Dull, aching pain in the groin, outer thigh or buttocks
• Pain that is worse in the morning and lessens with activity
• Increased pain and stiffness with vigorous activity
• Pain that limits your movements or makes walking difficult

There are several types of rheumatic diseases that can affect the hip joint and connective tissues:

• Osteoarthritis – This is the most common form of arthritis, also known as "wear and tear" arthritis. It often occurs in your hips, because your hip joints — like your knees and spine — are weight-bearing joints. This chronic rheumatic disease damages and thins the hip joint's articular cartilage, the smooth and glistening covering on the ends of your bones that enables your hip joint to glide smoothly. Osteoarthritis also narrows the space in which the hip joint moves. Osteoarthritis predominantly affects older people, but it also can occur in young people as a result of a hip injury or overuse.
• Fibromyalgia – This chronic condition causes pain, stiffness and tenderness of the muscles, tendons and joints without the detectable inflammation evident in many other rheumatoid diseases that affect the joints.
• Rheumatoid arthritis – This inflammatory disease attacks the lining of your hip joint (synovium) and is one of a group of inflammatory arthritis diseases known as inflammatory arthritides. Rheumatoid arthritis is a systemic autoimmune disease that can attack any joints in your body. A chronic disease, it is characterized by periods of flare-ups and remissions and can affect people of all ages. Rheumatoid arthritis of the hip can cause permanent destruction and deformity of the hip joint even before symptoms are severe. The cause of rheumatoid arthritis of the hip is unknown.

Other forms of arthritis of the hip or related disorders that can affect the hip are:

• Ankylosing spondylitis – This condition is one of the inflammatory arthritides, a group of diseases that attacks the lining of your joints (synovium). Ankylosing spondylitis is a chronic inflammation of the spine and the sacroiliac joint (the point where the spine meets the pelvic bone) that also can cause inflammation in other joints.
• Systemic lupus erythematosus – This autoimmune disease is one of the inflammatory arthritides, a group of diseases that causes inflammation of the body's connective tissues.
• Gout – This painful condition most often attacks small joints, but also can attack the hip. Gout is a result of a defect in body chemistry such as uric acid in the joint fluid.
• Scleroderma – A very serious disease of the connective tissues, scleroderma causes thickening and hardening of the skin.
• Juvenile rheumatoid arthritis (JRA) – This form of arthritis in children ages 16 or younger causes inflammation and stiffness of the joints for more than six weeks. Unlike adult rheumatoid arthritis which lasts a lifetime, children often outgrow JRA.

Nonsurgical treatments such as anti-inflammatory medicines, physical therapy and an assistive device such as a cane or walker can help reduce the pain and discomfort of arthritis of the hip. If nonsurgical treatments fail to provide relief, you may need surgery. Depending on the type of arthritis or a related disease mentioned above, your orthopedist may recommend:

• Total hip replacement surgery – usually recommended for people with rheumatoid arthritis or ankylosing spondylitis.
• Hip resurfacing – If you have advanced arthritis of the hip, you may be a candidate for either traditional total hip replacement (arthroplasty) or hip resurfacing (hip resurfacing arthroplasty). Each of these procedures is a type of hip replacement, but there are important differences that should be discussed with your orthopedic surgeon.
• Synovectomy – This surgical procedure removes part or all of the hip joint lining. It is usually recommended for people with rheumatoid arthritis or ankylosing spondylitis, if the disease is limited to the joint lining and hasn't affected the cartilage. People with systemic lupus erythematosis have a higher incidence of osteonecrosis (weakened bone structure due to the death of bone cells). They may be helped by these surgical procedures:
  • Bone grafts – May help build new bone cells to replace those affected by osteonecrosis
  • Core decompression – Reduces bone marrow pressure and encourages blood flow