Coxarthrosis or Osteoarthritis of the Hip

Hip pain that gets gradually worse over time is the first symptom of osteoarthritis of the hip. The pain is centered on the groin*The groin is the area between the bottom of the stomach and the top of the thigh. and radiates along the thigh, sometimes down to the knee. It is a mechanical pain, which means that it appears with physical exertion. It is worst at the end of the day. Pain can also be accompanied by a feeling of stiffness or loss of joint flexibility, especially after a period of inactivity.

In the morning, the hip feels stiff when the person wakes up. Walking becomes increasingly painful and it may eventually be necessary to use sticks to walk. Even actions like picking up an object, putting on socks, getting into the car, and climbing the stairs risk triggering pain in the joint.

People with osteoarthritis of the hip often experience flare-ups that correspond to the joint becoming more inflamed. Other symptoms include increased sensitivity around the joint and a sensation of rubbing or cracking when moving.

In contrast to common belief, osteoarthritis of the hip is not always connected to aging. It is sometimes diagnosed in people under the age of 40. However, osteoarthritis of the hip does become considerably more common with age.

80% of cases feature the following:

• an injury to the hip joint from an accident (a fracture or dislocation),
• une dégénérescence cartilagineuse due au port de lourdes charges (travail de manutention, construction),
• an anatomical deformation (for example knock knees, bow legs, or legs that are different lengths),
• or a disease such as rheumatoid arthritis*A chronic inflammatory disease of the joints and in particular the feet and hands. or diabetes*Diabetes is a disease that affects the way the body regulates blood sugar levels. *.

The influence of being overweight on the onset of osteoarthritis of the hip is the subject of debate.

Aside from repeatedly carrying heavy loads, ligament injuries*Ligaments are very strong tissues that connect the different parts of a joint (cartilage). Some accidents (in particular when playing sport) can cause ligament injuries, or preexisting anatomical abnormalities, several factors seem to be linked to the onset of osteoarthritis of the hip. These include a family history of the disease (a close relative having the condition), age, sex (the disease becomes more common with age and affects menopausal women in particular), and inflammatory or metabolic diseases. Repeated trauma or a history of joint injuries can also increase this risk.

There are some simple non-medical measures you can take to treat the pain, such as:

• wearing shock-absorbing shoes,
• using a walking stick and continuing to move to keep your muscles strong,
• opting for low-impact forms of exercise (cycling and aquafit, for example),
• attending physiotherapy sessions, and applying hot and cold compresses.

In terms of medication, you can take pain relief (generally paracetamol or non-steroidal anti-inflammatory drug such as ibuprofen or diclofenac) during flare-ups, possibly alongside corticosteroid injections.

There is no treatment to cure osteoarthritis of the hip however. We can only slow its progress and therefore delay the point at which surgery needs to be considered. This comes when the pain and loss of mobility have too significant an impact on the person’s quality of life.

The most common surgery is a hip replacement using a prosthesis. Over time, there is minimal wear of these prostheses thanks to the materials used to make them. Their lifetime is estimated to be 15–20 years. This surgery provides very good results in over 90% of patients in terms of pain and mobility. In most cases, people regain physical abilities and a quality of life that are similar to those they experienced previously.

Osteoarthritis of the hip is a chronic, slowly evolving disease. At first, pain is felt only during physical exertion. As time goes on, discomfort and later pain is felt when walking, sometimes requiring the person to use walking sticks.

Even actions as benign as putting on your socks or getting into a car become a source of pain. The disease progresses with flare-ups of inflammation accompanied by joint pain.

The pain connected to osteoarthritis of the hip can be limited by taking non-medical measures. For example, you can install handrails in the bathroom and toilet to help you get up more easily. If you use a walking stick, it is better to hold it in the opposite hand, next to the hip that does not hurt. We can provide the most relief to the painful joint by supporting the healthy side.

Physical activity, as long as it is low impact (exercise in water, walking, and cycling) and done in moderation, i.e. two or three times per week, is recommended to preserve muscle strength and slow the progression of the disease.

Physical therapy*An allied health discipline that treats bone, joint, and muscle conditions using physical manipulations and massages. or hydrotherapy can also be beneficial. Finally, it is important to keep an eye on your diet and avoid preprepared dishes and cured meats and instead prioritize healthy fats (unsalted nuts and seeds, olive oil, avocado).

Stiffness in the hip when you wake up in the morning, joint pain that appears and/or increases when you move, and swelling or crackling inside the joint are all associated with hip osteoarthritis. See your doctor if you experience any of these symptoms.

Osteoarthritis of the hip is diagnosed through a combination of clinical examination and medical imaging. This means that a medical examination will be performed including tests both in a standing and lying down position, the patient will be observed walking, their medical history will be taken, and an X-ray will be performed to confirm the diagnosis of osteoarthritis of the hip. This diagnosis will be made by a rheumatologist, a sports physician or a hip surgeon.

1. What is osteoarthritis?
Coxarthrosis, or osteoarthritis of the hip, is a progressive wearing away of the cartilage of the joint connecting the femur to the pelvis, causing pain and loss of mobility.

2. What are the first signs of osteoarthritis?
The first signs include pain in the groin and thigh, morning stiffness and pain during everyday movements such as climbing stairs.

3. How can osteoarthritis be prevented?
Practising gentle physical activity, controlling your weight, avoiding repetitive movements on the hip and adapting your home environment can help prevent hip osteoarthritis from worsening.

4. What treatments are available for osteoarthritis?
Treatments include anti-inflammatories, physiotherapy, corticosteroid injections and, in advanced cases, hip replacement.

5. When should hip osteoarthritis surgery be considered?
Surgery is considered when pain and loss of mobility significantly reduce the patient's quality of life, despite conservative treatments.