II. Epidemiology
- Most common cause of Anterior Hip Pain in older adults
III. Symptoms
IV. Signs
- Pain worse with Hip Range of Motion (hip flexion, hip rotation)
- Decreased Hip Range of Motion
V. Differential Diagnosis
- See Hip Pain Causes
VI. Imaging
- See Hip XRay in Osteoarthritis
- Standing Anteroposterior Pelvis XRay (first-line study)
- Degree of osteophytes and joint space narrowing does not correlate with symptom severity
VII. Management
- Non-Surgical Management
- See Osteoarthritis
- See Knee Osteoarthritis Management
- Hip Osteoarthritis conservative management includes many of the same therapies as Knee Osteoarthritis
- Surgical Management
- Indications
- Refractory pain despite conservative management (e.g. limits walking, sleep, sitting)
- Loss of mobility even with joint unloading (e.g. Crutches, cane)
- Modifying Factors Complicating Hip Arthroplasty
- Peripheral Vascular Disease
- Leg Length Discrepancy (e.g. hyperlordotic spine, oblique Pelvis)
- Reduced Hip Range of Motion (e.g. flexion contractures, limited hip flexion <90 degrees)
- Total Hip Arthroplasty (THA)
- Substantial pain improvement in 80% of cases
- THA lasts 20 years
- Acute Complications in 5% (PE, MI, Infection, Pneumonia) and mortality 1%
- Chronic Complications
- Prosthetic Hip Dislocation (1-3%)
- Periprosthetic Fracture
- Prosthetic loosening
- Prosthethic hip Septic Joint
- References
- Varacallo (2022) Total Hip Arthroplasty Techniques, StatPearls, Treasure Island
- Indications
VIII. Complications
- High morbidity (pain, significant functional limitations in ADLs)
- Deconditioning with decreased Physical Activity