Therapy of hip arthrosis

• consultation
• General indication criteria
• Common surgical procedures
• Possible consequences and complications
• Joint replacement (artificial hip joint)

Hip pain

Are you looking for the cause of your hip pain or you don't know exactly what is causing your hip pain?
Then let yourself be guided by our diagnostic Hip pain guide and come to the most likely diagnosis.

introduction

As general goals of the various therapy options in a Hip osteoarthritis apply: The reduction of pain and associated the Improvement of the "quality of life". This primarily includes maintaining or improving mobility (releasing tension, normalizing muscle functions), walking performance and delaying the progression of the Coxarthrosis (Hip osteoarthritis).

It is usually important to eliminate the so-called "disruptive factors". This includes, for example, axis misalignments (Leg length difference), one-sided overloads, Obesity or metabolic disorders. This may not always be easy.

1. Conservative therapy

consultation

As part of advising the Hip osteoarthritis patients are informed about the disease, its natural course and how it can be influenced by possible forms of therapy. Due to the large number of individual invoices, such advice is always of an individual nature. Individual lifestyle habits in particular are taken into account here.
As part of the conservative therapy of hip arthrosis

• No lifting of heavy objects and no athletic overexertion, etc.

Appointment with a hip expert?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Medical therapy

This form of therapy the Hip osteoarthritis does not treat the cause. The drug treatment rather serves to reduce pain and reduce inflammation.
There are different ways of doing this. You can treat systemically and locally with various groups of substances. This will be explained in more detail below.

• Anti-inflammatory drugs (NSAIDs)
  Medication such as Diclofenac, Ibuprofen and also the new so-called Cox-2 inhibitors e.g. Celebrex belong to this group of drugs.
• Steroids
  Steroids are usually only injected locally and therefore close to the hip joint. This is one of the steroids, for example Cortisone.
• Anti-inflammatory agents:
  These include anti-rheumatic, cortisone-free drugs, but also cortisone itself. Side effects occur relatively frequently. For this reason, therapy should only be carried out on medical advice!
• Cartilage protection preparations
  Cartilage protection preparations (e.g. Hyaluronic acid or chondroitin sulfate) are classified as promising in the early stages of osteoarthritis.
  Treatment therefore appears to be particularly useful in the early to middle stages of osteoarthritis.
  In order to be effective, however, these substances must be injected (see below).
• Naturopathy
  special is the Devil's claw to call. The devil's claw can be used alone for mild pain and to support the existing therapy for more severe pain. The devil's claw is said to reduce the symptoms of hip arthrosis.
  One can support in the therapy of a coxarthrosis through Homeopathic medicines. Various homeopathic medicines can alleviate symptoms in osteoarthritis therapy.
  You can find out more about this topic at: Osteoarthritis and Homeopathy
• Syringe treatment
  around or in the affected joint, usually with cortisone with a local anesthetic. Alternatively, one can have osteoarthritis in the early and middle stages Hyaluronic acid inject into the joint. This can improve the pain situation and mobility again.

Physical therapy

The possibilities of physical measures in the Hip osteoarthritis are very diverse. Some conceivable measures are listed below:

• physical therapy (physiotherapy)
• Massages (also: underwater massages)
• Moist warmth (Moor packs, ...)
• mobilization, Muscle strengthening, Muscle stretching and coordination training.
• Thermotherapy (Heat / cold therapy)
• Hydro and balneotherapy (Water / air therapy)
• Electrotherapy (Current therapy)
• Pull treatment on the leg (with a weight of approx. 1 kg) to achieve relaxation of the hip muscles.

Orthopedic measures

• Stick or crutch on the healthy side. The patient must learn a special walking technique when using this measure: First the walking stick and the sick leg are put forward together, then the healthy one follows
• So-called buffer heels
• Wedge cushions, booster seats, arthrodesis chair, relief orthoses

2. Operative therapy

Nowadays a Hip osteoarthritis Operations carried out on the one hand to prevent an impending deformation, but also to combat pain or to restore it.

General indication criteria

• Cause of arthrosis, Stage of the disease, previous course
• Pain, suffering
• Are there other joint diseases?
• Individual factors (age, general condition and accompanying diseases)
• Compliance and motivation, work situation, social status, level of activity of the patient

The selection of the surgical procedure for hip arthrosis depends to a considerable extent on the indication criteria. As a result, various surgical procedures are available.
You can find detailed information on the topic of hip osteoarthritis therapy in our Book hip osteoarthritis

Common surgical procedures

• Joint-preserving operations
  Corrective osteotomies on the femur and pelvis
  Will be a Hip osteoarthritis diagnosed, it is always checked whether a joint sustaining operative measure the complete replacement of the hip joint (Hip arthroplasty) can be prevented. In doing so, one primarily takes into account any pre-arthrotic changes, so to speak specific changes that would almost inevitably lead to the development of osteoarthritis in the corresponding joint areas.

This includes:

• a too steep or too shallow femoral neck angle, which is corrected, for example, as part of an intertrochanteric osteotomy of the thigh,
• a too shallow pan that can be deepened by a so-called pelvic osteotomy,
• Misalignments after fractures

Nowadays the Stiffening (= arthrodesis) the hip is only performed in special cases. The stiffening primarily achieves freedom from pain. A possibly unavoidable Hip replacement however, it turns out to be very difficult to install if the hip has already been stiffened in advance.

As you can see from the descriptions, they are different Replacement osteotomies can only be used very individually. Certain requirements must always be met.

It can thus be stated that joint-preserving operations are used to correct misalignments of one or both joint bodies. The main aim is to improve the mechanical stress in the area of ​​the hip joint and improve the progression of the arthrosis be delayed. The chances of success of a corrective osteotomy are higher if the joint-preserving operation takes place in the early stage of osteoarthritis. Thus, the chances of success decrease as the arthritis stage increases.

• Planning and preparation:
  • Implants, instruments
  • Measures to save foreign blood
  • Intraoperative X-ray option
  • Plan sketch

more on the subject Surgery for hip osteoarthritis

Possible consequences and complications

As general risks and complications be valid:

• the formation of hematomas = formation of bruises,
• Wound healing disorders,
• Wound infections,
• depth Leg vein thrombosis,
• embolism,
• Vascular and / or nerve injury

Special / specific consequences:

• Leg length difference
• mostly temporary gluteal insufficiency (= permanent weakening of the gluteal muscles)
• Broadening of the hip silhouette

Complications

• Delayed fracture healing,
• failure of bone fracture healing,
• Implant failure,
• Loss of correction, persistence of pain (pain remains)

Joint replacement (artificial hip joint)

As part of an endoprosthesis operation, all of the destroyed joint parts are first completely removed. These removed joint parts are then replaced with artificial ones. As a result, the patients usually become pain-free.

Meanwhile are Hip prostheses As such, it is “durable” for a long time, although replacement operations are particularly common in young and active patients. Therefore, the time of operation should be chosen carefully. However, if the quality of life is significant, e.g. is limited by nighttime pain, hip replacement surgery should be performed.

It should also be considered that the longer the implantation takes, the greater the risk of loosening.

One can therefore state:
Younger patients with severe hip osteoarthritis should undergo an operation if all conservative treatment options have been exhausted.
You can find detailed information on complications of hip osteoarthritis in our Book hip osteoarthritis