Hip Osteoarthritis
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Clinically Relevant Anatomy
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The hip joint is a synovial ball and socket joint, with the convex femoral head articulating with the concave acetabulum. Stability of the joint is achieved through a combination of muscle action and several ligaments forming a loose, but strong joint capsule, the iliofemoral ligament, the ischialfemoral ligament and the pubofemoral ligament. Another ligament, the ligamentum teres, does not provide stability to the hip but offers a portion of blood supply to the femoral head in some individuals.
The femoral head and acetablum are covered by smooth hyaline cartilage, and the acetabulum contains a labrum, which functions to facilitate movement and support the forces passed through the joint.
The hip, despite the requirement to support the weight of the body, has the second largest exursion of motion of any joint in the body.
External Link: [Hip Anatomy Video]
Mechanism of Injury / Pathological Process
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Clinical Presentation[edit | edit source]
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Diagnostic Procedures[edit | edit source]
Altman et al have established guidelines by which clinical diagnosis of hip osteoarthritis can be made. The guidelines, established in 1991, present a 3 pronged approach to diagnosis of hip osteoarthritis including clinical, radiological, and laboratory findings. According to these guidlelines, a patient was considered to have osteoarthritis if they presented with:
- Hip Pain and...
- Hip Internal Rotation < 15 degrees and Hip Flexion less than or equal to 115 degrees
or, hip pain in combination with:
- Hip Rotation < 15 degrees or...
- Pain with Hip Internal Rotation or...
- Hip stiffness in the AM less than 60 minutes or...
- Age > 50 years
More recently, Sutlive et al have proposed a clinical prediction rule to identify individuals with hip osteoarthritis presenting with unilateral hip pain.
Management
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Special Considerations[edit | edit source]
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Key Evidence[edit | edit source]
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Resources
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Related Pages[edit | edit source]
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