OA of Hip

Question 1

most common disease process affecting the hip

Answer 1

degenerative joint disease / osteoarthritis

Question 2

where are cartilaginous changes are seen first in OA

Answer 2

in the non-articular areas of cartilage

areas found in DJD are first seen in areas of cartilage that undergo most weight bearing

Question 3

predisposing factors for DJD

Answer 3

1. leg length disparity - on hip of longer leg side

in standing - discrepancy would cause the long limb to assume a position of adduction which would cause greater stress on lateral roof of acetabulum

2. capsular tightness
3. hip jt is not continually brought close to its closed packed position during activities
4. at push off when walking, the hip is brought into extension, IR, abduction, taking most of the slack in jt capsule by twisting the capsule on itself - casuing compression

Question 4

symptoms:

Answer 4

• pain on WB
• groin / trochanteric pain
• decreased internal rotation and extension
• capsular pain enhanced by low grade inflammation that develops as disease progresses

Question 5

where is pain typically felt first

Answer 5

groin then referred farther into the L2/L3 segment to anterior thigh and knee

Question 6

if significant adduction and flexion contractures are present how would the pt stand

Answer 6

heel raised
hip laterally rotated and pelvis elevated on affected side

Question 7

passive movements would be limited in what movements

Answer 7

abduction
flexion
internal rotation

(capsular patter of restriction) in no order

Question 8

treatment goals in early stages

Answer 8

restore normal joint mechanics
prevent further progression of disease
increase functional strength
decrease pain

Question 9

treatment goals in moderate-advanced stages

Answer 9

restore function to optimal level
restore joint mechanics to optimal level

Question 10

at push off in gait cycle the hip is brought into _____, ______, and ________

Answer 10

extension, medial rotation and abduction