Introduction
Osteoarthritis (OA) of the hip is the second most common presentation of OA after the knee. It accounts for significant morbidity and total hip replacement is now one of the most common operations performed in the developed world.
Epidemiology
- Incidence: 500.00 cases per 100,000 person-years
- Peak incidence: 70+ years
- Sex ratio: more common in females 1:1
| Condition | Relative incidence |
|---|---|
| Osteoarthritis of the hip | 1 |
| Greater trochanteric pain syndrome | 0.60 |
| Acetabular labral tear | 0.10 |
| <1 | 1-5 | 6+ | 16+ | 30+ | 40+ | 50+ | 60+ | 70+ | 80+ |
Aetiology
Risk factors
- increasing age
- female gender (twice as common)
- obesity
- developmental dysplasia of the hip
Clinical features
Features
- chronic history of groin ache following exercise and relieved by rest
- red flag features suggesting an alternative cause include rest pain, night pain and morning stiffness > 2 hours
- the Oxford Hip Score is widely used to assess severity
Investigations
Investigations
- NICE recommends that if the features are typical then a clinical diagnosis can be made
- otherwise plain x-rays are the first-line investigation
Management
Management
- oral analgesia
- intra-articular injections: provide short-term benefit
- total hip replacement remains the definitive treatment