Hip osteoarthritis (coxarthrosis): Information & specialists

Hip osteoarthritis is a degenerative disease of the hip joint. It is caused by wear and tear of the cartilage surface of the acetabulum and the femoral head. In patients, hip osteoarthritis manifests itself through severe pain, restricted movement in the area of the affected joint and changes in gait (limping).

Below you will find further information on the symptoms and treatment of hip osteoarthritis as well as selected coxarthrosis specialists.

What is hip osteoarthritis?

In healthy people, the cartilage ensures that there is only indirect friction between the femoral head and the femur. Various underlying diseases can lead to progressive wear and tear of the cartilage in the hip joint. This phenomenon is known as hip osteoarthritis or coaxarthrosis (ICD code: M16).

In contrast to dormant hip osteoarthritis, signs of inflammation are present in activated hip osteoarthritis. The smallest pieces of cartilage tissue are then shed into the joint fluid and trigger inflammation.

The video shows joint wear and tear due to cartilage damage:

Hip osteoarthritis goes unrecognized for years and usually only becomes apparent in older adulthood. X-ray and ultrasound examinations are used as diagnostic tools.

How does hip osteoarthritis develop?

Hip osteoarthritis is always caused by wear and tear of the joint cartilage. The cartilage becomes thinner and thinner as it progresses, tears and roughens. Initially, only small areas are affected by the damage. The patient initially has no symptoms.

As the cartilage breaks down, the pressure on the underlying bone increases more and more. Subchondral sclerosis develops on the bone. These are ossifications of the hip joint to compensate for the increased pressure and abrasion.

To compensate for the pressure, the joint surface enlarges and forms osteophytes, which make the hip joint more immobile. This process progresses until the cartilage layer is completely worn away and the bones lie on the opposite bones without protection.

Osteoarthritis is a wear and tear disease that affects the joint cartilage © Henrie | AdobeStock

What are the causes of hip osteoarthritis?

The causes of coxarthrosis can basically be divided into two groups.

Primary cause

Particularly in patients over the age of 50, it is often not possible to assign an exact cause of osteoarthritis. It is simply a congenital weakness in the body. It arises due to age-related degradation processes.

Secondary causes

Secondary causes include

• Congenital deformities(hip dysplasia),
• accidental injuries to the hip joint (usually as a result of an acetabular fracture),
• persistent overloading due to daily repetitive movements,
• obesity and
• inflammatory diseases(rheumatism).

What are the symptoms of hip osteoarthritis?

Hip osteoarthritis is a chronic disease that usually develops over several years.

The main signs of the disease are

• Increasing pain in the hip joint,
• increasing movement restrictions and
• muscle tension.

In the case of activated hip osteoarthritis, which can occur in phases during the course of the disease, there is often also

• Swelling,
• redness and
• overheating

occur.

The following symptoms characterize advanced coxarthrosis:

• Start-up pain: The patient feels pain at the start of movement, especially after long periods of rest.
• Joint pain that occurs during exertion
• Pain at rest: The patient feels pain when lying or sitting.
• Gait disturbances: After prolonged exertion, a slight buckling of the side affected by the osteoarthritis is evident.
• Restricted movement: The thigh is more difficult to bend, turn and stretch. The patient feels pain when spreading the thigh.

How is hip osteoarthritis diagnosed?

Physical examination to diagnose coxarthrosis

The examination begins with a physical examination in which

• gait,
• posture,
• muscle weaknesses,
• posture and
• possible misalignments

are at the center of attention. With advanced osteoarthritis in the hip joint, internal rotation of the leg and deep flexion (when sitting) are no longer possible.

Imaging procedures for the diagnosis of hip osteoarthritis

The narrowing of the joint space between the hip and thigh bone and the associated loss of cartilage are clearly visible on an X-ray. The narrower the joint space, the more advanced the hip osteoarthritis.

Osteophytes and subchondral sclerosis are also visible on the X-ray image.

Important for the digital planning of a hip prosthesis is

• the femoral neck angle and
• the distance between the center of rotation of the femoral head and the femur.

In some cases, special examinations such as

• MRI,
• CT or
• scintigraphy

are used.

How is hip osteoarthritis treated?

The course of coxarthrosis is variable and depends on many different individual factors.

There are various treatment options. They range from conservative measures to the use of an artificial hip joint.

Conservative treatment

In the early stages of hip osteoarthritis, patients can be treated with special measures such as

joint-friendly movement sequences,

• massages,
• physiotherapy,
• orthopaedic shoes, etc.

can do a lot to slow down the progression of the disease.

If the disease is more advanced, medication to relieve pain and inhibit inflammation can help.

Otherpreventive measures include weight loss and movements that place little strain on the hip joint.

The use of a hip prosthesis for hip osteoarthritis

In the final stage of hip osteoarthritis and if the quality of life is severely impaired, surgical methods should be considered. The use of a hip prosthesis is a conceivable option,