Post Traumatic Osteoarthritis of the Hip Joint: Causes, Signs, Treatment, Exercises

Osteoarthritis is often seen in the older patients. Osteoarthritis is also occasionally seen in younger athletes participating in contact sports. Repeated injuries of the same joint triggers degenerative changes in hip joint causing osteoarthritis.^[1] Posttraumatic osteoarthritis of the hip is also known as osteoarthritis of the hip, degenerative osteoarthritis of the hip, and hip osteoarthritis.

Posttraumatic osteoarthritis of hip joint in athletes following sport injury is often referred to as the benign progressive degenerative disease of the joints.^[2]

Osteoarthritis in the hip is a condition where the surface of the joint of the hip gradually wear away resulting in inflammation. This may happen because of a specific previous injury and due to over repetitive forces on the hip, which goes beyond the tolerance limit of the hip after a certain period of time.

The cartilage is a hard, slippery tissue that works like a cushion for the bones in the joints of the hip and helps the bones to glide easily while performing movements. The cartilage covering helps the hip joint to perform movements painlessly and smoothly. As mentioned earlier, osteoarthritis of the hip is a condition, which results from wearing down of this cartilage. The wearing down of the cartilage usually happens over a period of time. This often makes the slick surface of the cartilage rough and creates difficulty for the bones to glide easily and ultimately leaving the bone ends to rub on one another, which wear down. Eventually this may also develop small bony processes known as osteophytes.

Osteoarthritis in the hip usually occurs due to damaging or overloading, specifically with excessive weight bearing and twisting force and trauma to the hip. Traumatic osteoarthritis of the hip usually affects after individuals less than 50 years of age.^[3]

The exact cause of osteoarthritis of the hip is still not known, however, suspected causes may include.^[4]

• Improper formation of joints.
• Genetic defects in the cartilage.
• Performing activities that put extra stress on hip joints.
• Being overweight.
• History of repeated hip joint injury.
• Trauma to the hip joint.
• Leg length discrepancy.
• Poor core stability.
• Poor biomechanics.
• Excessive and inappropriate activity.
• Multiple Joint injuries.

Post Traumatic Osteoarthritis of the Hip leads to symptoms that develop gradually over time. However, few cases may not exhibit the symptoms of osteoarthritis in the hip. Symptoms of osteoarthritis in the hip may include:^[5]

• Hip Pain- Exacerbation of hip pain while performing weight bearing activity.
• Stiffness in the joint, specifically first thing in the morning and after rest.
• Severe pain is experienced in the joint.
• Reduced hip flexibility.
• Hip pain may be experienced at night.
• Grinding sensations may also be experienced while performing certain movements.
• The hip pain is usually felt in the buttock area.
• The hip pain is usually felt in the front side of the groin and hip.
• Symptoms can be fluctuating from time to time, especially with exacerbation in cold and damp weather.
• Muscle wasting particularly of the gluteals and a limp could also be present in severe cases.

There is no proper cure available for treating osteoarthritis of the hip. Therefore, its treatment concentrates on controlling the symptoms in order to slow down the progression of disease.

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDS): Non-steroidal anti-inflammatory drugs like ibuprofen help in providing temporary relief from pain.
• Weight Loss: Weight loss helps in slowing down the progression of the osteoarthritis in the hip.
• Exercise Program: Exercise program helps in maintaining healthy cartilage and range of motion of the joint. Efforts toward keeping the tendons and involved muscles strong and well conditioned helps in improving and maintaining joint stability.
• Muscle Relaxants: Low doses of muscle relaxants help in relieving pain from strained muscles, which may be a result of osteoarthritis of the joints.
• Cold and Heat Therapy: Application of cold and heat helps in relieving inflammation and pain followed by exercise.
• Viscosupplementation: Viscosupplement injections are also helpful in suppressing the inflammation. Viscosupplement is a substance that not only helps in lubricating the knee joint, but also reduces the amount of inflammation.
• Hip Replacement: Hip replacement operation is more frequently adopted procedure.^[6]

Physical Therapy for Post Traumatic Osteoarthritis of the Hip Joint

Physical therapy is required for all the patients to speed up the healing process and restore normal functioning. Physical therapy may include:

• Soft tissue massage.
• Electrotherapy such as ultrasound.
• Joint mobilization.
• Application of heat and ice.
• Exercises to improve flexibility, strength and balance.
• Hydrotherapy.
• Education.
• Using crutches or other walking aids.
• Walking re-education.
• Lifestyle and activity modification.
• Biomechanical correction.
• Anti-inflammatory and supplement advice such as chondroitin and glucosamine.
• Weight loss advice.
• Appropriate footwear and orthotics.

Lye down on back. Now gradually bring the knee towards the chest as far as possible until a mild to moderate pain free stretch is felt and return back to the beginning position. Perform 10 to 20 times ensuring there is no exacerbation of symptoms.

This exercise is performed by lying down on the back. By keeping the knee in a straight position move the leg sideways as far as possible until a mild to moderate pain free stretch is felt and return back to the beginning position. Make sure that the toes and the knee cap is facing the ceiling while performing this exercise. Perform 10 to 20 times ensuring there is no exacerbation of symptoms.

This exercise is performed by lying down on the back with foot flat and knee bent. Now move the knee sideways as far as possible until a mild to moderate pain free stretch is felt and return back to the beginning position. Perform 10 to 20 times ensuring there is no exacerbation of symptoms.

This exercise is performed by lying down on back by standing the legs with knees facing towards the ceiling and feet flat on the floor. Gradually raise the bottom by pushing it with the help of feet in order to bring the hip, shoulder and knee in a straight line by tightening the bottom muscles. Hold the position for about two seconds until a pain free stretch is felt. Repeat it 10 times^[7]

A complete subjective and physical examination is necessary to diagnose the condition of osteoarthritis in the hip. Typically the following diagnostic tests may be required for confirming the severity and extent of damage.

• X-rays.
• MRI.

References:

Also Read:

• Hip Sprain: Causes, Symptoms, Treatment, Exercises
• Q&A: Hip Joint Pain Treatment Approach and Options–Everything You Need To Know
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• Hip Joint Psoriatic Arthritis: Causes, Symptoms, Treatment, PT, Surgery
• Enthesopathy of Hip: Causes, Symptoms, Treatment