The most common form of arthritis of the hip joint is osteoarthritis (OA). This is characterised by pain and stiffness in the hip, usually worsening over time.
There is, however, another form of arthritis that can affect the hip joint. It is called rheumatoid arthritis (RA) – a chronic, inflammatory, progressive autoimmune disease.
Here, we take a look at the differences between these two forms of arthritis, what causes them and how they can be treated.
OA of the hip is often known as a ‘wear and tear’ condition. This means that it can really affect anyone, as it is caused by overuse of the hip joint. This can occur in sport, or as a result of occupations which involve repetitive squatting. A break of the hip joint can also lead to OA years later. Problems with the hip in childhood and subtle anatomical mismatches between the ball and socket joint can also lead to OA in later years.
It usually presents in older people, however there is an increasing prevalence of osteoarthritis in younger people. It commonly starts in the 50s and affects women more than men.
Mainly affecting those who have led extremely active lives, or who are seriously overweight, it leads to pain mainly felt in the groin and difficulty bending down to put shoes & socks on or to get out of a low chair.
Rheumatoid arthritis causes
Rheumatoid arthritis is an autoimmune condition. This is when the body’s immune system has decided to turn on itself and start attacking healthy cells. It is still unknown exactly why this happens, but it is believed to have a genetic link. This sets up an inflammatory reaction in the joint with synovitis (inflammation of the joint lining) and erosions into the bone. The bone often becomes softer than in OA and this can lead to deepening of the hip socket and thinning of its floor.
Rheumatoid arthritis is more common in people with a family history of the condition. And similarly to OA, it also tends to affect more women than men.
Symptoms – osteoarthritis versus rheumatoid arthritis
The main difference in the symptoms of osteo versus rheumatoid arthritis, is that the problem may affect just one hip joint, rather than both. In both conditions pain is felt in the groin area or buttocks and sometimes on the inside of the knee or thigh.
Sufferers of both conditions may also experience a grinding sensation when trying to use the affected hip. Furthermore, they may find that the joint seems to ‘lock’ into place.
Rheumatoid arthritis often affects both hips. But people who have rheumatoid arthritis often first experience symptoms in the smaller joints, such as in the hands or feet. Then it spreads to larger joints like the hips. Other specific symptoms of RA include:
- Pain and stiffness that may feel worse in the morning or after periods of resting or sitting
- Pain that may lessen with movement and increase with vigorous physical activity
Treatment – osteo versus rheumatoid arthritis
Because rheumatoid arthritis is a chronic, progressive condition, symptoms are often managed using medication to prevent ‘rheumatoid flares’. This can help to alleviate some of the pain and swelling and in recent years, with the introduction of novel drugs, has led to a large reduction in severe rheumatoid cases.
Osteoarthritis can also be treated with medication, but other ways of managing symptoms are also recommended. People often find relief by making lifestyle changes and minimising the activities that aggravate the condition. This might mean switching your sport of choice to something lower impact.
With both osteo and rheumatoid arthritis, surgery is something of a last resort. If your symptoms cannot be relieved with medication or lifestyle adjustments, then hip replacement surgery may be the answer.
Generally, total hip replacement surgery presents the best option for arthritis sufferers. This removes the whole hip joint and replaces it with a new surface. Mr Punwar uses both cemented and uncemented stems with excellent long-term results together with an uncemented metal socket. Cemented sockets are sometimes used with very weak bones, particularly in rheumatoid sufferers. Hip replacement relieves the pain of arthritis and restores movement to the hip joint.
Hip replacement surgery can have a dramatic impact on the quality of life. But you should always be aware of the risks, and be able to make an informed decision about the best time to undergo surgery. For more information, please call us on 020 8194 8541 to arrange a consultation with Mr Punwar.