Osteoarthritis in the hip may result from multiple causes, such as a significant overweight, trauma, vascular factors (known to be the cause of aseptic necrosis of the femoral head) also may result in dislocations and other vascular damage as in the future may produce hip osteoarthritis. However, the most common cause seen in our service was primary osteoarthritis, meaning osteoarthritis which is caused by progressive degeneration of cartilage, as by the the natural evolution of human beings.

When the joint cartilage is lost, autonomy is more and more each time, limiting not only for walking but for the simple things in life such as putting on socks, getting out of bed, cutting your finger nails etc.Figure 2 shows a normal hip x-ray, note that there are two green lines, one that surrounds the head of the femur and the other the acetabulum, between the two you see a space, that space is not air, but cartilage.

Figure 2: anteroposterior radiograph of left hip joint without injury.

Note in Figure 3, the difference again between the green lines that line the images depicted in Figure 2, see that space has decreased to such an extent that at the top both lines touch, this picture shows the beginning of osteoarthritis.

Figure 3: Left hip osteoarthritis in the upper pole

La figura 4 muestra de forma animada lo que representa el daño de la articulación de manera severa.

Figure 4: a very good anatomy of left hip joint, to the right damage on both surfaces of the bone (femur and acetabulum) formal indication for replacement

For the diagnosis, all that is required in most cases, is a protocol of plain radiographs, not invasive or painful. And a rigorous physical examination.

Treatment

When you have a debuting osteoarthritis, it can be treated with non-steroidal, anti-inflammatory drugs (do not forget to take proton pump inhibitors) you can apply local heat, weight loss, exercise may be added and the use of cane, among other things.To this medical treatment you can add a rehabilitation treatment, use the ultrasound option and exercises that maintain muscle tone and range of motion as normal as possible, and of course follow a protocol that we will give you in the query.

Figure 5: anti-inflammatory drugs

Figure 6: rehabilitating your hip

If medical treatment does not work and autonomy is compromised to the point that makes it almost impossible to walk, you need a joint replacement. Hip prostheses consist of a total replacement of its articulation, as shown in the figures. One option is a total arthroplasty of the hip with a minimally invasive approach as shown in Figure 7. Figure 8 shows x-rays before and after the intervention.

Figure 7: note the total replacement of your right hip. This is a total prosthesis.

Figure 8: X-ray on left hip osteoarthritis, and a control x-ray right after the replacement.

In some cases it is possible that your hip is eligible for what is known as hip resurfacing, this is what Americans know as patching of hip and Europeans as resurfacage.This resurfacing is the latest technology concerning joint replacement, it has two components, a femoral and an acetabular, it has the advantage of preserving more bone, less invasive and there has a faster recovery. Figure 9 shows some examples.

Figure 9: To the left resurfacing components. To your right control radiograph (x ray).

Intervention by either resurfacing or total hip arthoplasty, will give you the ability to walk the day after surgery, settled your feet with no trouble or pain, stay in our medical center for about 3 days, then return home, and little by little regain your autonomy, drive your car after 1 month and the recommendations we explain will last 3 months.