Treating Painful Hip Arthritis

Hip pain often results from arthritis due to wear-and-tear. Treatments start with nonsurgical options and can lead to a total hip joint replacement, as McLeod Orthopedic Specialist Christopher Walsh, MD explains.

Here’s a summary of Dr. Walsh’s explanation:

So, what is hip arthritis? All the joints in our body are covered with a smooth, gliding surface called cartilage. Over time, that cartilage wears away. Eventually you’re rubbing bone on bone, resulting in quite a bit of pain. Pain associated with hip arthritis is generally located in the groin and can sometimes spread around the hip. You notice it most significantly when you’re seated and getting up to a standing position or with a different range of motion and movements.

Just because you have hip arthritis doesn’t mean we turn straight to surgery. There’s a number of nonoperative measures that we use to treat hip arthritis at the onset. First, we try anti-inflammatory medication. Next is physical therapy, which does very well to strengthen the muscles in the region, help stabilize the joint and can often buy the patient a lot of time before we consider hip replacement.

The second thing we can try is corticosteroids, anti-inflammatory injections directly into the hip to decrease the pain and the swelling.

If those measures no longer help, we start talking about operative options, usually a total hip joint replacement. There are two main options to the hip to reach the joint structure that needs to be replaced – the anterior (front) approach and the posterior (rear) approach.

The posterior approach, a gold standard, has been around since the beginning of hip surgery in 1950s and 60s, when it became popularized and mainstream. The incision is about 8-10 centimeters long just behind the bone, on the back side of the hip. It’s incredibly common. We do many of these and use it for patients with a lot of deformity and problems in the hip.

Over the last 10 to 15 years, as technology increased, there’s been a surge of anterior hip replacements. At McLeod Seacoast, we have a specialized table operating room setup to enable us to perform an anterior approach surgery.

The benefits of the anterior approach include a smaller incision and a somewhat faster recovery from surgery. Most of the time, we tell patients it will take about six weeks to fully recover. You’re on the walker for about a week or two, transition to a cane and then back to normal walking right after that.

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