What is osteoarthritis of the hip?
Osteoarthritis is the most common disease of our joints and also the most frequent reason for disability of the locomotor system. It is characterized by a wearing away of the layer of cartilage that covers our joints, with bone tissue forming in its place. The hip joint consists of a hemispherical cavity which is the acetabulum of the pelvis and a ball that articulates in it which is the head of the femur. Both surfaces are covered with cartilage. The cartilage is a tissue that cushions the loads and, at the same time, it is a smooth and soft covering that allows the movements of a joint.
But after the age of 30, cartilage ages rapidly and becomes softer and more fragile. Cracks and erosions appear on its surface, exposing the bone. As a result, the hip joint with osteoarthritis becomes irregular, resulting in limited mobility, pain and disability.
How does osteoarthritis of the hip manifest itself?
It mainly manifests itself with discomfort, the pain usually appears with the mobility of the joint and when walking. And it usually disappears with rest but in more advanced stages the pain can be nocturnal and interrupt sleep.
What factors are predisposing to osteoarthritis of the hip?
They can be family history, since osteoarthritis is hereditary, obesity -predisposes to osteoarthritis since overweight overloads our joints-. Likewise, jobs that involve overloading or continuous impact on our hips also predispose to osteoarthritis of the hip. And finally, some diseases such as rheumatoid arthritis or congenital malformations of the hip or trauma or fractures in the hip can also predispose to this disease.
What is the initial treatment for osteoarthritis of the hip?
There are several forms of treatment, first of all we advise to eliminate overweight, losing weight contributes significantly to reduce pain in osteoarthritis of the hip. We also advise gentle exercises to maintain mobility and prevent atrophy of the hip muscles. In the initial phases some anti-inflammatory drugs or physiotherapy can also help, however, with the passage of time these measures cease to be effective and the disability becomes increasingly greater and it is at that moment when we consider the possibility of an operation to place the hip prosthesis.
When should a prosthesis be placed?
The placement of a hip prosthesis is indicated when the joint has advanced wear and tear and other treatments have already been tried without success. The surgical procedure consists of removing the damaged parts of the joint and replacing them with components called implants. These implants consist of a hemispherical cup to replace the acetabulum of the pelvis and a stem that is inserted into the femur to which a spherical head is connected. The materials of these implants are compatible with our tissues (polyethylene, ceramic or metals such as titanium or chromocobalt). There are models of prosthesis that are fixed to the bone with the help of a special acrylic cement and other models that are placed without cementing and require a perfect fit to the bone. These implants have a rough surface and micropores through which the bone grows, in this way, the uncemented implants are fixed or integrated in a practically biological way in the bone surface. Generally, prostheses are cemented to the bone in older people or in people with weak bones and are placed without cementing in the more resistant and younger bones.
How long do the prostheses last?
Hip prostheses have a limited life span that varies from person to person. With the new materials, the life span is much longer and can be estimated at 12 to 15 years or more.