Hip Arthritis Treatment Options
Hip Arthritis Treatment in the early stages should encompass retention of hip movement by exercises such as walking. Water-based rehabilitation is particularly useful to retain muscle tone. Physiotherapy can be of some assistance. Weight reduction where appropriate is important. Avoidance of impact such as running may be necessary.
Non-steroidal anti-inflammatory pain medication (NSAID) such as Ibuprofen or Diclofenac is frequently helpful in the early stages. NSAIDSs are less effective in established hip arthritis.
Diagnostic hip aspiration can be helpful in relieving pain in patients with acute reactive synovitis.
Hip arthroscopy is a form of keyhole surgery. It may be particularly effective in young athletic symptomatic patients who have developed early degenerative change centred on the superior
acetabular roof. This may involve debridement and and/or repair of the acetabular lip/ labrum).
Cutting the pelvic or femoral neck (Osteotomy) is still advocated in selective patients with Congenital Hip Dysplasia. The indications are quite strict with potential success or failure
being patient dependent factoring in the severity of degenerative change.
Hip replacement surgery is indicated where all conservative measures have failed and/or the level of hip arthritis is too far advanced.
Hip replacement entails removing the diseased arthritic femoral head and replacing the lining of the acetabular hip socket with either a metal shell and plastic insert or cementing a plastic liner directly. The femoral head is replaced with a ball attached to a stem, inserted into the femoral marrow shaft. Modern technology favours use of a Ceramic femoral head with polyethylene plastic (COP) liner or metal on plastic liner( MOP).
Surgery can be undertaken accessing the hip from the front, side or back. The access sites reflect surgical preference. Outcome measures are the same at 6 months with some modest earlier discharge from hospital for younger patients undergoing the anterior approach. Surgery takes approximately one hour usually, using regional spinal anaesthetic, with sedation.
Patients undergoing primary hip replacement normally undergo medical pre-assessment and screening to confirm that it is safe to proceed. Patients are in hospital for approximately 3 days. Same-day joint replacement surgery is increasingly becoming a consideration.
Following surgery, patients undertake intensive supervised rehabilitation optimally by walking in water and attending physiotherapy. Most patients should wean down to a crutch or stick, 6 weeks from the day of surgery. Recovery is very patient dependent.
Patients will be reviewed by their Orthopaedic surgeon post operatively to ensure a satisfactory outcome.