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Common Conditions and Treatment Options

Common Conditions, Symptoms and Treatments

Common Conditions:

While hip pain can stem from deformity, trauma or sports-related injury, the most common cause is osteoarthritis, also known as degenerative joint disease.  Based on factors such as age, weight, joint function, and activity, osteoarthritis gradually erodes the hip’s cartilage lining. Eventually, bones begin to rub against each other, resulting in friction, swelling, pain, stiffness, and instability.

Arthritis is one of the most common causes of joint disorders. More than 50 million people in the United States are diagnosed with arthritis.[1]  A brief overview of the common types of arthritis are included below.[2] To learn more about hip pain and the common conditions and treatments please visit www.aboutstryker.com.

Osteoarthritis

You may have heard Osteoarthritis (OA) referred to as "wear and tear" arthritis. When OA begins to affect one of your joints, a series of reactions take place that actually begin to degrade your once-healthy bone and the "soft tissue" around the joint – tendons and cartilage. Once the cartilage that normally cushions and protects the bones of the joint breaks down, the bones of your joint eventually rub directly against each other. Your body reacts to this by creating bone spurs and the joint capsule itself may thicken and weaken. Inflammation eventually sets in.

Symptoms:

  • Pain
  • Joint stiffness (especially in the morning)
  • Swelling
  • Tenderness
  • Possible crunching sound in joints

Possible Treatment Options:

  • Anti-inflammatory medication
  • Cold packs to help reduce inflammation
  • Local injection of cortisone to further reduce inflammation
  • Orthotic devices such as: 
    • custom-made shoes
    • shoe inserts
    • braces
    • a cane
  • Surgical procedures such as: 
    • arthroscopic debridement (removing inflamed and/or irritating debris from the joint)
    • arthrodesis (fusing the joint for greater support)
    • arthroplasty (replacing the arthritic joint)
  • Physical Therapy

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease in which the body's natural immune response wreaks havoc on the lining of the joints (called the synovial membrane), causing chronic inflammation and pain. The inflammation may eventually damage the joint's cartilage and bone, weaken the soft tissue around the joint (cartilage, ligaments and tendons) and prevent the joint from working properly.

Symptoms:

  • Stage 1:
    • Pain
    • Warmth
    • Redness 
    • Swelling
  • Stage 2:
    • Thickening of the joing lining
  • Stage 3:
    • permanent joint damage occurs as bone and cartilage are attacked by the enzymes released by the inflamed cells in the affected joint's once-healthy cushioning fluid (called synovial fluid).

In addition to joint pain, swelling and stiffness, the symptoms of RA commonly include fatigue, weakness, flu-like symptoms accompanied by a low-grade fever, loss of appetite, depression, chronic dry eye or dry mouth and, in people with more advanced RA, bumps (called rheumatoid nodules) under the skin.

Possible Treatment Options:

Your rheumatologist may recommend different treatment options depending on the severity of your RA and its impact on your joint(s) and your body as a whole.

  • Non-steroidal anti-inflammatory medications (NSAIDs)
  • Analgesics, steroids
  • Disease modifying anti-rheumatic drugs (DMARDs)
  • Biologic response modifiers that work on the immune system.
  • Surgical procedures such as:
    • Arthroscopic debridement (removing inflamed and/or irritating debris from the joint)
    • Arthrodesis (fusing the joint for greater support)
    • Arthroplasty (replacing the arthritic joint)

Post-Traumatic Arthritis

Post-traumatic arthritis may develop after an injury to the joint in which the bone and cartilage do not heal properly. The joint is no longer smooth and these irregularities ultimately lead to more wear on the joint.

Symptoms:

Injury to a joint, such as a bad sprain or fracture, can cause damage to the articular cartilage. Once this cartilage is damaged, it does not normally grow back. The defects are filled with scar tissue, which is not as good a material for covering joint surfaces as the cartilage.

Possible Treatment Options:

Post-traumatic arthritis is treated similarly to osteoarthritis.

  • Anti-inflammatory medication
  • Cold packs to help reduce inflammation
  • Local injection of cortisone to further reduce inflammation
  • Orthotic devices such as:
    • custom-made shoes
    • shoe inserts
    • braces
    • a cane
  • Surgical procedures such as:
    • arthroscopic debridement (removing inflamed and/or irritating debris from the joint)
    • arthrodesis (fusing the joint for greater support)
    • arthroplasty (replacing the arthritic joing)

Paget's Disease

Paget’s disease is a bone disease that often affects the hip. Bone formation is sped up, causing the density and shape of the bone to change. The mis-shapen bones affected become large, but also weak.

Symptoms:

For many people, Paget’s Disease has no symptoms. Others may discover they have the disease when being tested for unrelated ailments. However, some may have symptoms related directly to the affected bones or symptoms that are complications of the bone malformation. These include bone deformities and pain due to microfractures in the bone.

Possible Treatment Options:

  • Medication
  • Pain Relievers
  • Regular exercise
  • Vitamin D
  • Surgery, if the above treatments do not relieve the pain and joint damage

Avascular Necrosis

Also called osteonecrosis, it is a disease that results from a loss of blood supply to the bone. Without adequate blood flow, sections of bone eventually die, weaken and collapse. Because this is most often seen at the ends of bones, your joints may be greatly affected. This is especially true of the hip joint, as osteonecrosis most commonly appears at the end of the femur (the long bone that extends from the knee to the hip joint). Medical experience has shown that wherever osteonecrosis causes bone to degrade in a joint, arthritis develops.

Symptoms:

Patients with early stage osteonecrosis may not have any symptoms. Later symptoms include:

  • Pain
  • Diminished range of motion
  • Development of osteoarthritis

Possible Treatment Options:

  • Non-steroidal anti-inflammatory medications (NSAIDs)
  • Blood thinners (to increase blood flow to the affected bone)
  • Cholesterol-lowering medications if corticosteroid use has elevated your cholesterol level
  • Crutches to reduce weight bearing on the affected joint
  • Range of motion exercises
  • Physical therapy
  • Electrical stimulation
  • Surgical options such as:
    • osteotomy (re-shaping the bone)
    • bone grafting (which may help your body create healthy new blood vessels and bone cells)
    • arthroplasty (replacing the affected joint).
 

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