Information About Hip Replacement Surgery for Patients and
Their Families
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Life After Hip Replacement
Hip Arthritis
Arthritis of the hip is a disease which wears away the cartilage between the
femoral head and the acetabulum, the two bones will scrape against each other,
raw bone on raw bone. When this happens, the joint becomes pitted, eroded and
uneven. The result is pain, stiffness and instability. In some cases, motion of
the leg may be greatly restricted.
Osteoarthritis
Osteoarthritis, which is the most common form of arthritis in the United
States; it is degenerative and although it most often occurs in patients over
the age of 50, it can occur at any age, especially if the joint is in some way
damaged.
It is usually confined to the large weight-bearing joints of the lower
extremities, including the hips and knees, but may affect the spine and upper
extremity joints, too. Patients with osteoarthritis often develop large bone
spurts, or osteophytes, around the joint, further limiting motion.
Causes
Osteoarthritis of the hip is a condition commonly referred to as "wear and
tear" arthritis. Although the degenerative process may accelerate in persons
with a previous hip injury, many cases of osteoarthritis occur when the hip
simply wears out. Some experts believe there may be a genetic predisposition in
people who develop osteoarthritis of the hip. Abnormalities of the hip due to
previous fractures or childhood disorders may also lead to a degenerative hip.
Osteoarthritis of the hip is the most common cause for total hip replacement
surgery.
Symptoms
The first and most common symptom of osteoarthritis is pain in the hip or
groin area during weight bearing activities such as walking. People with hip
pain usually compensate by limping, or reducing the force on the arthritic hip.
As a result of the cartilage degeneration, the hip loses its flexibility and
strength, and may result in the formation of bone spurs. Finally, as the
condition worsens, the pain may be present all the time, even during non
weight-bearing activities.
Treatment
Before considering total hip replacement surgery, your doctor and you may try
various non-surgical therapies. An appropriate weight reduction program may be
beneficial in decreasing force across the hip joint. However, weight reduction
can be difficult for people with hip arthritis since the arthritis pain
precludes them from increasing their activity and burning calories. An exercise
program may be instituted to improve the strength and flexibility of the hip and
the other lower extremity joints. Lifestyle and activity modification may be
undertaken in an attempt to minimize the activities that are associated with hip
pain. Finally, various medications such as non-steroidal anti-inflammatory drugs
(NSAIDs) and/or nutritional supplements (Chondroitin/Glucosamine) to reduce pain
and inflammation associated with the disease may be considered.
Assistive devices like a cane or a crutch can help to reduce the force
transmitted through the hip joint during walking and thereby may help to
decrease hip arthritis pain. If non-surgical treatment is unsuccessful, you and
your surgeon may decide that a total hip replacement is the best available
treatment option..
Rheumatoid Arthritis
Unlike osteoarthritis which is a "wear and tear" phenomenon, rheumatoid
arthritis is a chronic inflammatory disease that results in joint pain,
stiffness and swelling. The disease process leads to severe, and at times rapid,
deterioration of multiple joints, resulting in severe pain and loss of function.
Causes
Although the exact cause of rheumatoid arthritis is unknown, some experts
believe that a virus or bacteria may trigger the disease in people having a
genetic predisposition to rheumatoid arthritis. Many doctors think rheumatoid
arthritis is an autoimmune disease in which the synovial tissue of the joint is
attacked by one’s own immune system. The onset of rheumatoid arthritis occurs
most frequently in middle age and is more common among women.
Symptoms
The primary symptoms of rheumatoid arthritis are similar to osteoarthritis
and include pain, swelling and the loss of motion. In addition, other symptoms
may include loss of appetite, fever, energy loss, anemia, and rheumatoid nodules
(lumps of tissue under the skin). People suffering with rheumatoid arthritis
commonly have periods of exacerbation or "flare ups" where multiple joints may
be painful and stiff.
Treatment
Treatment of rheumatoid arthritis may involve medications such as NSAIDs,
aspirin and analgesics. Corticosteroids, such as prednisone may be prescribed,
and are effective in decreasing the inflammation associated with rheumatoid
arthritis. Side effects can occur with the use of corticosteroids, and close
monitoring by a physician is essential. Researchers have made progress in the
treatment of rheumatoid arthritis and newer prescription drugs are now
available. If non-surgical measures fail, you and your surgeon may decide that
total hip replacement is the best treatment option to relieve your pain and help
you return to an improved functional level.
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