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Hip joint wear (osteoarthritis)
When the hip joint is worn
The hip joint consists of the rounded femoral head and the cup-shaped acetabulum. Contact areas are covered with soft cartilage tissue. Synovial fluid ("synovia"), which is generated by the mucous membrane, nourishes the cartilage and lubricates the joint. Various factors cause this cartilage coating to wear down until the joint bones are completely exposed. This loss of cartilage is called osteoarthritis.
The likelihood of developing hip osteoarthritis increases with age. Signs of joint wear can be seen in many people as early as at the age of 40. Nevertheless, osteoarthritis is not just a disease of old age.
Apart from age, there are the following causes and risk factors for coxarthrosis:
Excessive load: For example, if you are overweight or have an unusually high load on your joints due to competitive sports or heavy physical work
Pathological load distribution: Joint misalignments, such as bowed legs or X-shaped legs, or other disorders and injuries, such as broken bones that lead to permanent adaptive posture and thus poor posture
Metabolic diseases: Deposition of uric acid crystals in the joints, e.g. in gout, favours cartilage damage
The diagnosis of hip osteoarthritis is confirmed by examinations and targeted X-rays. Typically, the joint space is absent or narrowed, the bone tissue underneath the cartilage is thickened, there are local bone cavities (cysts) all the way to a complete bone destruction, and there are ossifications at the joint margin.
In the early stages, conservative measures can still be used to alleviate the symptoms. For example, weight loss in overweight patients may help. Walking sticks and physiotherapy may also relieve the pain of hip osteoarthritis. Treatment with hyaluronic acid gel, which is injected into the joint, can improve gliding of the cartilage and deliver cartilage building blocks directly to the joint. If chemical substances cannot be used, a few millilitres of patient's own blood can be processed into the so-called platelet-rich plasma (PRP). This can be injected into the affected area. For pain treatment, we offer both Chinesebody acupuncture and special ear acupuncture, either as standalone treatments, or in addition to the conservative measures.
If osteoarthritis is already at an advanced stage, usually only artificial joint replacement (total hip replacement, prosthesis) is recommended.
Coxarthrosis in younger patients
In younger patients with hip complaints and only slight signs of osteoarthritis in X-ray images, the treating physician should also think of a still relatively unknown early form of the disease, the so-called "femoro-acetabular impingement syndrome". In certain cases, this early form can be successfully treated by minimally invasive keyhole surgery (arthroscopy).
Inflammation of the synovial bursa of the hip (trochanteric bursitis)
When lying on your hip is painful
The so-called bursitis should be considered if it is painful to lie on the hip bone on the side of the thigh, and if the hip is painful when walking or pressing on it. This means that a buffer underneath the muscles on the thigh is inflamed and hurts. There may even be swelling and redness that is visible from the outside. The treatment is generally simple: rest, avoiding strain, wearing flat shoes, taking ibuprofen or similar medications. Alternatively, a few millilitres of patient's own blood can be processed into the so-called platelet-rich plasma (PRP). This can be injected into the affected area. Cortisone injections are also sometimes used. Shockwave therapy is very successful in these cases. It has few side effects, it is not painful, and it is covered by most private health insurance funds and workers’ compensation boards. X-ray irradiation is also an option. Acupuncture may help relieve pain and reduce swelling. In difficult cases, keyhole surgery (endoscopy) may be performed to remove the synovial bursa.