Osteoarthritis
Summarizing hip osteoarthritis (coxarthrosis) as mere cartilage wear in the elderly is an oversimplification. There are many forms of osteoarthritis, and some forms occur earlier due to underlying small anatomical malformations, life accidents, or traumatic sports practices.
Sometimes, osteoarthritis manifests insidiously, with poorly identified pains, causing professional difficulties, interruptions in a sports career, or discomfort in intimate life.
Identifying these causes, the anatomical variability of hips among individuals, as well as the personal, professional, physical, and athletic aspirations of each patient is fundamental for successfully implementing a therapeutic plan.
Symptoms
Pain is the primary symptom of hip osteoarthritis. This pain generally follows a mechanical pattern, meaning it is associated with movement, walking, sports activities, and diminishes with rest. However, inflammatory flare-ups can occur, causing night-time or resting pain.
It is most often located in the groin fold, the lateral side of the hip (trochanteric region), and the buttock, with pain radiating to the thigh, knee, and sometimes the front of the leg.
There may also be mechanical symptoms such as locking, snapping, and instability.
Progression
Osteoarthritis progresses towards a gradual worsening, marked by phases of flare-up (worsening) and relief, and a stiffening of the joint. Over time, sitting, driving, walking, and even simple actions like putting on socks or trousers become difficult. It leads to a highly disabling situation. There is no spontaneous cure for this condition.
Early Forms
Chondropathy, a localized cartilage damage, is the earliest form of osteoarthritis. It occurs in young individuals and is usually the result of unfavorable anatomical conditions, exacerbated by intensive sports activities, severe trauma to the hip joint (sports accident, road accident), or joint disease (rheumatic diseases).
Some minor hip malformations have been identified only recently, and their connection with the onset of hip osteoarthritis is now clearly understood. Hip impingement (femoroacetabular impingement), hip dysplasia, or hip instability are conditions identifiable in young individuals, which can now benefit from early management, helping to limit or delay the need for hip prosthesis.
Joint diseases such as chondromatosis, villonodular synovitis are conditions that can lead to hip osteoarthritis. These pathologies can benefit from innovative and minimally invasive techniques such as hip arthroscopy, delaying the onset of coxarthrosis while improving the quality of life of patients.
Non-Surgical Treatment
The first treatment for osteoarthritis will be medical. It will be based on adapting activities, weight loss, analgesic and anti-inflammatory medications. Sometimes, joint injections of cortisone or viscosupplementation can bring significant improvement.
Therapies based on stem cells or plasma (PRP) currently do not yield satisfactory results.
Surgical Treatment
If osteoarthritis is detected early, certain malformations promoting its development can be corrected by arthroscopy (femoral cam, labrum lesion, etc.).
Hip replacement will be the effective solution once osteoarthritis is established and resistant to medical treatment. A personalized 3D planning, combined with a rigorous surgical technique that preserves the musculature, and the choice of custom-made implants will be the most suitable solution to restore optimal personal, professional, and sports quality of life, even in younger subjects.