Hip Arthritis

Arthritis of the hip is a disease which wears away the cartilage between the femoral head and the acebulum, the two bones will scrape against each other, raw bone on raw bone. When this happens, the point becomes pitted, eroded and uneven. The result is pain, stiffness and instability. In some cases, motion of the leg may be greatly restricted.


Osteoarthritis is the most common form of arthritis in the United States. It is degenerative and although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.

It is usually confined to the large weight-bearing joints of the lower extremities, including the hips and knees, but may affect the spine and upper extremity joints, too. Patients with osteoarthritis often develop large bone spurs, or osteophytes, around the joint, further limiting motion.

The first and most common symptom of osteoarthritis is pain in the hip or groin area during weight bearing activities such as walking. People with hip pain usually compensate by limping, or reducing the force on the arthritic hip. As a result of the cartilage degeneration, the hip loses its flexibility and strength, and may result in the formation of bone spurs. Finally as the condition worsens, the pain may be present all the time, even during non weight-bearing activities.

Rheumatoid Arthritis

Unlike osteoarthritis which is a "wear and tear" phenomenon, rheumatoid arthritis is a chronic inflammatory disease that results in joint pain, stiffness and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.

The primary symptoms of rheumatoid arthritis are similar to osteoarthritis and include pain, swelling and the losses of motion. In addition, other symptoms may include loss of appetite, fever, anemia and rheumatoid nodules (lumps of tissue under the skin). People suffering with rheumatoid arthritis commonly have periods of exacerbation or "flare ups" where multiple joints maybe painful and stiff.

Non-surgical Alternatives to Hip Surgery

Lifestyle Modification

The first alternative to hip replacement involves such lifestyle modification measures as weight loss, avoiding activities involving long periods of standing or walking, and the use of a cane to decrease the stress on the painful hip.

Exercise and Physical Therapy

Exercise and physical therapy may be prescribed to improve the strength and flexibility of your hip and other lower extremity muscles. Your exercise program may include riding a stationary bike, light weight training and flexibility exercises. An aquatic therapy program is especially effective for the treatment of arthritis since it allows mild resistance while removing weight bearing stresses. For an appropriate exercise program, contact the experienced physical therapist.

Anti-inflammatory Medications

Arthritis pain is primarily caused by inflammation in the hip joint. Reducing the inflammation of the tissue in the hip can provide temporary relief from pain and may delay hip replacement surgery.

Cortisone Injections

Cortisone is a powerful anti-inflammatory and not a pain-relieving medication, it treats pain much more effectively; yet, it only relieves pain at the site of the inflammation. When the inflammation resolves, the pain is lessened. By injecting the cortisone directly into the site of inflammation, even giving high doses, there are usually, only minimal side-effects. A long-lasting effect can take place rapidly and give comfort to the patient, for many weeks.

Cortisone injections are safe, when given more than once. But, if the injections do not offer any relief, or wear off too quickly, you may want to seek an alternative method of care. Sometimes tendons can weaken and softening of cartilage may occur with repeated cortisone injections. Continuous injections may also increase the risk of a more serious problem; this is why many doctors do not give cortisone injections more than three times, consecutively.

Hip Resurfacing

Who is a Candidate for Hip Resurfacing?

Hip resurfacing is intended for young, active adults who are under 60 years of age and in need of a hip replacement. Adults over 60 who are living non-sedentary lifestyles may also be considered for this procedure. However, this can only be further determined by a review of your bone quality.

There are certain causes of hip arthritis that result in extreme deformity of either the head of the femur or the acetabulum (hip socket). These cases are usually not candidates for hip resurfacing.

Talk with Dr. Tilgner to determine if hip resurfacing is the right option for you.

Total Hip Replacement

If you and your surgeon have exhausted all conservative measures for treating your hip arthritis, you may be a candidate for total hip replacement surgery. This procedure is often the only option for reducing pain and restoring an active, pain-free life. If your doctor decides a total hip replacement is right for you, the following information will give you an understanding about what to expect.

Total hip replacement is a surgical procedure for replacing the hip joint. During the procedure, the two parts of the hip joint, the hip socket (acetabulum) and the ball (femoral head), are removed and replaced with smooth artificial surfaces. The artificial socket is commonly made of metal with a high density liner, and the artificial ball is made out of metal or ceramic.

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