Osteoarthritis of the hip is a degenerative condition that can be primary or secondary. Primary osteoarthritis is rare in India but common in Western countries. Secondary osteoarthritis, on the other hand, is often caused by trauma, Berthes disease, or avascular necrosis of the femoral head.
Causes and Risk Factors
Secondary osteoarthritis can develop due to various factors, including
– Trauma
– Berthes disease
– Avascular necrosis of the femoral head
– Fracture of the neck of the femur
– Dislocation of the hip
– Fractures of the acetabulum
Clinical Features
The presenting features of osteoarthritis of the hip include:
– Progressively increasing pain and limitation of movements
– Gradual restriction of all hip movements, except for flexion in some cases
– Painful weight-bearing and ambulation
Treatment
*Conservative Treatment
Initial treatment involves conservative management, including:
– Deep heating modalities
– Body ergonomics exercises
– Analgesics
– Weight reduction
– Use of walking aids
*Surgical Treatment
Surgical procedures may be performed, including
– Osteotomy to centralize weight-bearing axis
– Arthrodesis (at a late stage)
– Pauwell’s varus osteotomy
– McMurray’s displacement osteotomy
– Arthroplasty (total hip joint replacement)
*Physiotherapeutic Management
The objective of physiotherapy is to provide pain-free and functionally acceptable hip joint mobility.
*Control of Pain
Pain management techniques include:
– Ice massage
– Gentle intermittent traction
– Deep heating modalities
– Joint mobilization
*Joint Mobilization
Various methods of joint mobilization can be applied, including
– Relaxed ROM swinging exercises
– Small-range assisted free active movements
– Maitland techniques
– Hydrotherapy
– PNF techniques
*Muscle Strengthening
Improving the strength and endurance of important muscle groups, such as gluteal muscles, should be initiated. Controlled isometrics and progressive resistance exercises (PRE) can be used to strengthen these muscle groups.
Common Sites of Osteoarthritis
Osteoarthritis can affect various joints, including
– Hip
– Knee
– Hand
References:
1. Joshi J. Orthopedics. 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2013.
2. American Academy of Orthopaedic Surgeons. (2020). Osteoarthritis of the Hip.
3. Mayo Clinic. (2022). Hip osteoarthritis.
4. National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2022). Osteoarthritis.
5. Journal of Orthopaedic and Sports Physical Therapy. (2019). Hip Osteoarthritis: A Review of the Literature.
6. Physical Therapy. (2018). Exercise and Physical Therapy for Osteoarthritis of the Hip.