Hip Arthritis

What is Hip Arthritis?

Hip arthritis, also known as hip osteoarthritis, is a pain generating condition of the hip joint resulting from “wear and tear”. The articular cartilage, over time, begins to thin and even disappear, resulting in bone on bone contact in the hip joint. This cartilage is responsible for providing a smooth, “gliding” surface for the joint to rotate upon. Therefore, as this joint surface wears out, pain results. This process can be exacerbated by things like a rigorous physical activity resulting from occupation or sport. Additionally, increased body weight significantly affects symptom presentation. For every pound of body weight gained or lost, that equals 4-7 lbs of distributed force through the hip in either direction. Therefore, a pound lost provides significant help and a pound gained is all the more painful. Lastly, hip osteoarthritis also may have a genetic component, meaning regardless of lifestyle, body weight, or activity habits, some people are predisposed to develop early and severe arthritis. 

Conservative Treatment

It should be known that hip osteoarthritis is typically a progressive problem, meaning it will worsen over time as the joint continues to “wear”. However, there is a list of non-surgical interventions that may be beneficial and significantly delay and even prevent the need for invasive surgical procedures. The conservative treatment package typically includes activity modification, ice and course of scheduled anti-inflammatory medication. Additionally, discussions will be had regarding weight loss and the resources available to assist in dieting and activity management. As stated before, the weight loss effect is magnified by the fact that the hip joint itself sees more weight than your body carries. In addition, local anesthetic and steroid injections can be very successful at limiting arthritis symptom presentation. These injections may be given as frequently as every 3 months and must be stopped well short of a scheduled operation. When you visit Dr. Davis for hip arthritis, these treatment interventions will be recommended and attempted prior to moving on to a discussion regarding surgical intervention. 

** Prior to taking a scheduled anti-inflammatory regimen, patients should alert Dr. Davis of any pre-existing acid reflux/GERD. Additionally, prior to anti-inflammatory medication in the setting of pre-existing heart conditions, please obtain cardiovascular clearance from a primary care physician or cardiologist. 

Surgical Intervention

Once all conservative intervention has been exhausted and quality of life is still suffering, Dr. Davis will move to discuss operative intervention. Hip arthritis is treated surgically with a procedure called a hip arthroplasty, or total hip replacement. In its simplest form, this involves removing the bone and cartilage from the hip joint that causes pain and replacing it with a ball and socket joint made from artificial implants. This procedure has years of evidence based backing to prove its effectiveness and safety. Preoperatively, Dr. Davis will inquire about your medical history to be sure your baseline health allows you to undergo the procedure. You will also obtain preoperative radiographs, or x-rays, to assess anatomy, deformity and leg length. Using this data, Dr. Davis will template your implants to obtain precise intraoperative anatomic accuracy. Your individual case will be discussed at length during your preoperative clinic visit and all questions may be answered at this time. Dr. Davis typically performs a total hip arthroplasty through an anterior approach, or from the “front”, allowing for a minimally invasive, muscle sparing technique that minimizes operative time, maximizes implant accuracy, and minimizes dislocation risk. Occasionally, however, body habitus or bony anatomy may prevent this option and a posterior approach will be used. This will be discussed preoperatively as well. The procedure is also not without risks. Risks of anesthesia, bleeding, infection and implant failure are present, although very rare. Due to their rarity, patients are very often happy with their decision to proceed. Schedule a visit today to start your journey to pain relief. 

Post Op

The post-operative journey following a hip replacement is fairly consistent. On the day of surgery, you will get out of bed and be able to bear weight on your hip replacement with physical therapy. Immediately, you will know that the pain you have been experiencing for years has been eliminated. The purpose of such early mobilization is to restore confidence in your new joint in addition to minimizing your risk of developing a blood clot. Typically, this operation is followed by a night in the hospital. This allows for monitoring of labs, vital signs and pain. Pain will be addressed in a multimodal fashion to aid in your recovery. Occasionally, you will be able to have your surgery on an outpatient basis, avoiding your hospital stay altogether. This allows for you to return to the comfort of your own homes as soon as possible, minimizing the risk of hospital associated bacterial exposure. This will be discussed with you during your preoperative visit. Be prepared to take a blood thinning medication for a period of 30 days after surgery to minimize blood clot risk. Subsequently, you will be seen at the 2 week mark to assess your wound healing, followed by 6 week and 3 month visits to monitor your return to function, guided by physical therapy.