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OSTEOARTHRITIS OF THE HIP: Here’s Everything You Need To Know

dr andrew dutton osteoarthritis of the hip orthopaedic surgeon
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Did you know that osteoarthritis of the hip can sometimes lead to changes in the length of the affected leg? Initially, this change in leg length might be minor and not very noticeable. However, even a small discrepancy in leg length can alter the way a person walks. To compensate for the shorter leg, the person might start limping or leaning more to one side. These adaptations in the way we walk are the body’s way of trying to maintain balance and reduce discomfort during movement.

A recent study found that in 2020, the percentage of overall osteoarthritis cases in Singapore that were due to hip osteoarthritis ranged from 3.4% to 9.5%. If you or anyone you know is suffering from osteoarthritis of the hip, this blog will provide valuable insights into understanding the condition, managing symptoms, and treatment options available to you.

Degenerative Joint Disease Overview

Degenerative joint disease, commonly known as osteoarthritis, involves the gradual wear and tear of joint cartilage. This condition can affect any joint, but it’s particularly common in weight-bearing joints like the hips and knees.

As osteoarthritis progresses in the hip joint, it causes the cartilage—which acts as a cushion between the bones—to wear down. Over time, the cartilage degradation can result in bone rubbing against bone, which can cause severe discomfort and limit daily activities.

As this cartilage thins and the space between the bones in the hip joint decreases, the thigh bone (femur) can move slightly upward toward the pelvis, effectively shortening the leg on the affected side.
Gradually, these changes can impact our posture and balance, and put a strain on the lower back, for one, leading to additional joint and muscle issues.

Osteoarthritis of the Hip Causes & Symptoms

Osteoarthritis of the hip can develop at various ages, but it typically becomes more common and noticeable in middle-aged and older adults. The onset often begins in people in their 50s and 60s, and the likelihood of developing the condition increases with age.

However, younger individuals can also be affected, especially if there are predisposing factors such as:

  • Joint Injury. Injuries to the hip, such as fractures or dislocations, can lead to premature degenerative changes in the joint cartilage.
  • Obesity. Extra body weight increases stress on the hip joints, especially during movement, accelerating cartilage wear.
  • Genetics. A family history of osteoarthritis can predispose individuals to developing the condition in the hips.
  • Overuse. Repeated stress or overuse of the hip joint, often seen in athletes or certain occupations, can hasten cartilage degradation.
  • Medical Conditions. Conditions like rheumatoid arthritis or congenital abnormalities in the hip can also contribute to the development of osteoarthritis.

Common symptoms of osteoarthritis of the hip include:

  • Pain. The most common symptom, which may occur in the groin area, thigh, or buttocks. Pain typically worsens with activity and improves with rest.
  • Stiffness. The hip joint may feel stiff, particularly in the morning or after sitting for long periods. This stiffness usually eases with movement.
  • Limited Range of Motion. As the condition progresses, you may notice difficulty in performing movements that involve the hip, such as bending or walking.
  • Crepitus. A grinding noise or sensation may occur when the affected joint is used, caused by the rough surfaces of the bones moving against each other.
  • Swelling. The area around the joint may swell due to inflammation.

4 Stages of Osteoarthritis of the Hip

Osteoarthritis of the hip progresses through four stages, each reflecting the severity of the condition and the extent of joint damage.

Stage 1: Minor. Characterised by mild wear and tear of the hip joint. Generally, symptoms are not prominent in this stage. There may be very slight bone spur growths, but the cartilage typically remains in a healthy state, and the space between bones is normal.

Stage 2: Mild. You may start feeling more frequent stiffness and pain, particularly when sitting, standing, or walking for extended periods. While the cartilage remains at a healthy thickness, there may be noticeable growth of bone spurs and slight narrowing of the joint space.

Stage 3: Moderate. Pain becomes more regular and intense, especially after extended joint use. Moderate thinning of the cartilage and narrowing of the joint space become obvious. Bone spurs increase in size and may start to affect joint movement.

Stage 4: Severe. You might experience severe and persistent pain, even at rest. There is significant or complete loss of cartilage in the joint, leading to bone-on-bone contact. The joint space becomes greatly reduced or absent, and large bone spurs may develop.

Medical Treatment for Osteoarthritis of the Hip

Medications play a crucial role in managing symptoms of hip osteoarthritis. Over-the-counter pain medications like acetaminophen are commonly used. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, help reduce inflammation and alleviate pain, as well. For more advanced cases, corticosteroid injections directly into the hip joint can provide significant relief.

If osteoarthritis of the hip is left untreated, the condition progressively worsens, leading to compounding complications and chronic and debilitating pain that severely impact quality of life. Surgery may be considered when conservative treatments have failed.

One such surgery is total hip replacement, wherein the damaged hip joint is replaced with artificial components. Meanwhile, in a revision (redo) hip replacement, the prostheses themselves are replaced with another set of artificial parts. One or more parts, such as the stem, cup or the socket may be replaced, but there are cases where the entire replacement hip has to be changed.

On the other hand, hip resurfacing is considered particularly suitable for younger patients who are more active and likely to wear out a total hip replacement. The procedure involves trimming and capping the femoral head (the ball part of the hip joint) with a smooth metal covering, rather than completely replacing it. Similarly, the hip socket (acetabulum) is also lined with a metal shell.

Biologic Therapies for Osteoarthritis of the Hip

Singapore is known for its high standards in healthcare, and this extends to platelet-rich plasma (PRP) injections and stem cell therapies for the treatment of osteoarthritis of the hip. Clinics and hospitals offering these treatments must adhere to rigorous quality and safety standards.

PRP injections are particularly popular for treating osteoarthritis, with varying degrees of success. In some cases, patients experience relief for several months, whereas in others, the benefits may be shorter-lived, necessitating repeated treatments.

Meanwhile, stem cell therapy is an evolving area of medicine that offers potential benefits for managing chronic joint conditions. It has to be emphasised that stem cell therapy should only be administered by physicians with specialised expertise and relevant publications in the field. A/Professor Andrew Quoc Dutton, with his role as a Senior Consultant Orthopaedic Surgeon and a Fellow of Harvard Orthopaedic Surgery, aligns with this criteria.

Consulting with a certified and experienced specialist is essential to ensure that any interventions are safe and optimal. While this blog provides valuable information for understanding and managing your condition, it does not replace professional medical advice. Please book a consultation with A/Professor Andrew Dutton or call us at (+65) 6836 8000, and we would be happy to answer your questions.

A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic Insurance

The A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic offers minimally invasive and surgical treatments for sports-related injuries and orthopaedic conditions. To aid in the expenses that you may incur, we accept a number of corporate and international insurance. If you have any of the insurance plans below, please let us know when you book an appointment with us. If you need further assistance, you may drop us an e-mail at info@eliteortho.com.sg or call us at (+65) 6836 8000.
  • AIA Health Insurance
  • Alliance Healthcare
  • AXA International Exclusive (IE)/ IE Plus
  • Cigna International
  • Fullerton Health
  • Great Eastern Life/ Live Great
  • Integrated Health Plans (IHP)
  • MHC Medical Network
  • NTUC Income
  • Parkway Shenton Insurance/ iXchange
  • Raffles Health Insurance
  • Singlife with Aviva
  • Adept

Get the quality orthopaedic healthcare you deserve. Get in touch with our team today!

About A/Professor Andrew Quoc Dutton

A/Professor Dutton, also known as, has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. A/Professor Dutton has worked at the Prince of Wales Hospital, Sydney, and the St. George Hospital, Sydney, before completing his orthopaedic surgery training in Singapore. He is currently an associate professor of orthopaedic surgery at the National University of Singapore (NUS).

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