Hip osteoarthritis
- Osteoarthritis of the hip
- Clinical features
- Morning stiffness
- Inguinal pain or pain above greater trochanter
- Can refer to the thigh and knee
- Contractures (reduced ROM)
- First movement affected: internal rotation
- Limp
- Muscle atrophy around hip and thigh
- Limb length difference
- Diagnosis
- By conventional x-ray
- AP view and Lauenstein (frog-leg) view x-ray
- Narrow joint line
- Subchondral sclerosis
- Subchondral cysts
- Osteophytes
- Treatment
- Conservative
- Frequent exercise
- Especially joint-friendly exercises, like swimming, cycling
- Weight loss
- Physical therapy
- NSAIDs
- Orthopaedic shoes
- Crutch on affected side
- Frequent exercise
- Surgical
- Only if conservative treatment isn’t sufficient (late stage)
- Total hip replacement
- Hip arthroplasty is one of the most successful orthopaedic operations
- > 90% satisfaction rate
- 1,5 million procedures every year
- Can be used in any joint destruction
- Mostly in osteoarthritis or osteonecrosis of hip joint
- But contraindicated in case of ongoing local or systemic infection
- The prosthesis has no blood supply and antibiotics therefore can’t reach it -> provides good base for infection
- (Partial hip replacement)
- NOT used in orthopaedics -> only used in treatment of hip fractures
- Femoral head is replaced with prosthesis
- Acetabulum is preserved
- Total hip replacement (THR)
- Used in orthopaedics
- Femoral head is replaced with prosthesis
- Acetabulum is replaced with prosthesis
- Postoperative DVT prophylaxis
- Conservative