Hip Osteoarthritis


Hip Osteoarthritis, Degenerative Joint Disease of the Hip, Hip DJD, Hip Arthritis, Femoroacetabular Joint Osteoarthritis

  • Epidemiology
  1. Most common cause of Anterior Hip Pain in older adults
  • Symptoms
  1. See Hip Pain
  2. Gradual onset of pain with or without history of hip Trauma
  3. Pain with prolonged sitting or prolonged ambulation
  • Signs
  1. Pain worse with Hip Range of Motion (hip flexion, hip rotation)
  2. Decreased Hip Range of Motion
  • Differential Diagnosis
  • Imaging
  1. See Hip XRay in Osteoarthritis
  2. Standing Anteroposterior Pelvis XRay (first-line study)
    1. Degree of osteophytes and joint space narrowing does not correlate with symptom severity
  • Management
  1. Non-Surgical Management
    1. See Osteoarthritis
    2. See Knee Osteoarthritis Management
      1. Hip Osteoarthritis conservative management includes many of the same therapies as Knee Osteoarthritis
  2. Surgical Management
    1. Indications
      1. Refractory pain despite conservative management (e.g. limits walking, sleep, sitting)
      2. Loss of mobility even with joint unloading (e.g. Crutches, cane)
    2. Modifying Factors Complicating Hip Arthroplasty
      1. Peripheral Vascular Disease
      2. Leg Length Discrepancy (e.g. hyperlordotic spine, oblique Pelvis)
      3. Reduced Hip Range of Motion (e.g. flexion contractures, limited hip flexion <90 degrees)
    3. Total Hip Arthroplasty (THA)
      1. Substantial pain improvement in 80% of cases
      2. THA lasts 20 years
      3. Acute Complications in 5% (PE, MI, Infection, Pneumonia) and mortality 1%
      4. Chronic Complications
        1. Prosthetic Hip Dislocation (1-3%)
        2. Periprosthetic Fracture
        3. Prosthetic loosening
        4. Prosthethic hip Septic Joint
    4. References
      1. Varacallo (2022) Total Hip Arthroplasty Techniques, StatPearls, Treasure Island
        1. https://www.ncbi.nlm.nih.gov/books/NBK507864/
  • Complications
  1. High morbidity (pain, significant functional limitations in ADLs)
  2. Deconditioning with decreased Physical Activity