Osteoarthritis is a degenerative disease that causes the cartilage that normally cushions the ends of the bones in your joint to become damaged and start to wear away. It can affect any joint in the body but is particularly common in weight-bearing joints (hips and knees) and in the hands. Osteoarthritis is sometimes called ‘wear and tear arthritis’ because it is associated with ageing. It is more common in women than men and can also be caused by injury to the hip joint.
There is no cure for the condition, which gradually worsens over time, however starting treatment as early as possible can slow its development and lessen its impact on your life.
Symptoms of osteoarthritis
If you have been diagnosed with hip osteoarthritis you are likely to have a range of symptoms, which can vary in severity depending on how far the disease has advanced. The most common symptoms are pain and stiffness in the affected joint, particularly after a period of inactivity or when you first wake. The pain may radiate to your buttocks or knee and it tends to become worse during physical activity. Osteoarthritis causes a loss of movement and flexibility in your hip and this may affect your ability to walk or bend.
You may hear a grinding noise in your hip joint when you move. This is referred to as crepitus and it is caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip. These may also cause the hip joint to stick or lock. While these symptoms may be mild in the early stages of the disease, they tend to increase in severity as time goes on. In the latter stages, osteoarthritis can have a severe impact on your life and people with the condition can be prone to depression as it has such a detrimental effect on their quality of life and prevents them from doing many of the things they used to enjoy.
When is the best time for hip-replacement surgery?
One of the questions we get asked most often as orthopaedic surgeons is when a patient with osteoarthritis should undergo hip replacement surgery. There are a number of factors to consider. While prosthetic implants are improving all the time and their lifespan is increasing (currently, most implants last around 15-20 years), nevertheless, they will eventually wear out. When this happens you will need to undergo revision joint replacement surgery, which involves removing the worn-out prosthetic and replacing it with a new one.
The outcomes of revision joint replacement surgery tend to be poorer than primary joint replacements and the risk of complications is higher. For this reason, we advise younger patients to delay as long as possible before undergoing hip replacement surgery. The rationale for this is that the older you are when you have your primary hip replacement, the more likely it is to last for the remainder of your lifetime without the need for revision joint replacement surgery.
However, it is important to balance this against the impact that osteoarthritis symptoms can have on your life and your overall health and wellbeing. If you are in severe pain and the disease is preventing you from enjoying a good quality of life then it is important to get treatment and not to suffer long-term.
Non-surgical treatments of osteoarthritis
There are non-surgical treatments that can help to manage the symptoms of osteoarthritis and delay the need for you to undergo joint replacement surgery for as long as possible. An injection of corticosteroids and hyaluronic acid into the hip joint, using x-ray guidance to help achieve greater accuracy, can provide short-term pain relief. Although we generally don’t advise having this procedure more than three or four times as it can cause damage to the joint, it can be helpful for managing symptoms. Pain medication and physiotherapy may also help, along with lifestyle changes to manage your symptoms.
Ultimately, your orthopaedic surgeon will be able to advise you on the optimum time to undergo hip replacement surgery. Extended waiting times for NHS patients in the current climate means that more people are exploring the possibilities of undergoing surgery privately.