OA of Hip

Question 1

What is OA?

Answer 1

• Degenerative joint disease characterised by loss of articular cartilage

Question 2

What is the first and second most affected joint in OA?

Answer 2

• first: knee
• second: hip

Question 3

What are the RF for OA?

Answer 3

• Systemic
  
  • Age
  • Obesity
  • F
  • Vit D Deficiency
• Local
  
  • Hx of hip trauma
  • anatomic abnormalities
  • muscle weakness or joint laxity
  • High impact sports

Question 4

What are the clinical features of hip OA?

Answer 4

• Pain in groin, lateral hip or deep buttock
• Pain worsen by weight bearing, improved by rest
• Stiffness - improves with mobility
• Crepitations
• Antalgic gait
• Painful passive movement
• Red. ROM

If end stage OA

• fixed flexion deformity
• trendelenburg gait

Question 5

What are the differentials for OA hip?

Answer 5

• Trochanteric bursitis
  
  • lat hip pain radiate down lat leg
  • point tenderness over greater trochanter
• Gluteus medius tendinopathy
  
  • point tenderness over greater trochanter
• Sciatica
  
  • diagnosed with Lasegue’s sign
• #NOF
  
  • ​Hx of trauma

Question 6

What Ix woul you order for OA hip?

Answer 6

• Plain radiograph of hip (LOSS)
  
  • Loss of joint space
  • Osteophyte formation
  • Subchondral cysts
  • Subchondral sclerosis

Question 7

How would you mx OA of hip?

Answer 7

Initial

• Lifestyle modifictaion (weight loss, exercise, smoking cessation)
• WHO analgesic ladder
• Physiotherapy

Long term

• Total or hemiarthroplasty

Question 8

How long would a modern hip prosthesis last for?

Answer 8

• 15-20 years

Question 10

What are the indications for THA in Hip OA?

Answer 10

• end-stage, symptomatic or severe osteoarthritis
• preferred treatment for older patients (>50) and those with advanced structural changes
• recommendation is to wait at least 3 months after ipsilateral intaarticular hip injection to decrease risk of prosthetic joint infection