There are many types of arthritis that may lead to degeneration of the hip joint. The most common form is osteoarthritis. It is not always known why some people will have worn out their joints at age 40 while others still have normal cartilage at age 70.
Most patients who have severe hip arthritis at an early age have some underlying deformity of the hip; the most common in young men is cam FAI (cam type femoral acetabular impingement), while dysplasia is the most common deformity in young women. However, genetic factors that determine the quality of cartilage and level of activity may also play a role. In my experience 80% of men under 55 have cam FAI and 30% of women under 55 have dysplasia.
Types of Arthritis
- cam FAI
- pincer FAI
- profunda acetabulum
- protrusio acetabulum
- acetabular retroversion
- post traumatic (following fracture or dislocation)
- rheumatoid arthritis
- other inflammatory arthritis (AS, IBD, Psoriatic)
- osteonecrosis (avascular necrosis,) or Legg Perthes disease (bone collapse due to loss of blood supply)
- congenital dysplasia (child with hip deformity)
- SCFE (slipped growth plate)
The progression of arthritis from its earliest mild stages to its most severe crippling form is usually gradual. Initially, the pain occurs only after higher levels of activity. Later, it progresses and may become present at rest as well. Physical disability includes limp, muscle spasm, limited walking ability, decreased motion and stiffness, need for a cane, walker or even a wheelchair. The level of symptoms may fluctuate, but, generally, they worsen with time.
During its early stages, usually, arthritis can be treated with medication, supportive devices and modification of activities. However, as the cartilage on both sides of the joint wears away completely and the bone rubs on the bone, the arthritis has become “severe”. At this stage, placing a new artificial lining or surface on the joint (hip replacement) is usually the only effective way to relieve the symptoms adequately. Although there are many treatments that can lessen the symptoms of arthritis, there is no scientific evidence for any treatment to prevent further cartilage damage or to regenerate lost cartilage.