​Hip Osteoarthritis: Treatment Overview

In Singapore, hip fractures in those aged 50 and above have increased in the past 30 years. Women are five times more likely to have hip fractures compared to 1.5 times in men.

People with hip fractures suffer considerable loss of function and becomes dependent on others.

Hip OA cannot be cured, but therapies are available to relieve discomfort and control the degeneration of the joint.

• Your doctor may prescribe medicine to help control your pain.
• Physical therapy plays a critical role in the nonsurgical management of hip OA.
  • A primary goal is to help you learn how to control the symptoms and maximise the function of your hip.
  • You will learn ways to calm the pain and symptoms, which might include the use of rest, massage and heat therapy.
  • A walking stick or walking frame may be needed to reduce pressure on the hip when walking.
  • Range of motion and stretching exercises will be used to improve hip motion.
  • You will be shown strengthening exercises for the hip to steady the joint and protect it from further injury.
  • Your therapist can suggest tips for getting your tasks done with less strain on the joint.

In severe cases and when nonsurgical treatment is ineffective, surgical treatment of OA may be appropriate.

Arthroscopy (‘keyhole surgery’)

• Surgeons can use an arthroscope to look inside the hip joint to check its condition.
• An arthroscope is a miniature television camera inserted into the joint though a small incision.
• During the procedure, your surgeon may use several techniques to give you relief from pain.
• One method involves cleaning the joint by removing loose fragments of cartilage, and another method involves simply removing bits of tissue that may be irritating the hip joint.
• This procedure is sometimes helpful for temporary relief of symptoms, and is useful in some instances of early hip OA.

Artificial hip replacement

• An artificial hip replacement is the ultimate solution for advanced hip OA.
• This is the definitive treatment for severe hip OA, and is both safe and very effective.
• With advances in the design of artificial hips and also improvements in surgical technique, hip replacement can now be performed in both young and old patients, and can often be reasonably expected to last the lifetime of the patient.
• More advanced procedures, such as hip resurfacing, have the potential to offer even better function to younger patients with a very physically demanding lifestyle, whether in terms of work or play.
• However, even with conventional total hip replacement, most patients will be able to return to a normal lifestyle within 2 to 3 months of the surgery.

Ref: S13