The most common hip disorders found in Thai people are Osteoarthritis (OA), Developmental Hip Dysplasia (DDH), Avascular Necrosis, and hip disorder from rheumatoid related with long-term use of steroids, the amount of drinking alcohol, and congenital disorders, which can occur between the ages of 40-65. Arthritis that occurs at the hip joint is considered to be a disease that is common in elderly people, including at the joint capsule, joint tendon, and bones that assemble joints. When the patient gets older, they often gain weight. The structure inside the joint becomes abnormal. Therefore, there is an abnormality inside the joint. For example:
• The surface of the hip joint, which is cartilage, begins to deteriorate. The articular surface is not smooth and joint movement feels jammed, stiff, or makes noise like rubbing sandpaper.
• The weight distribution of the articular surface begins to be abnormal. Some areas become more serious. Some areas are reduced. Therefore, weight bearing becomes abnormal accompanied with stinging pain.
• Irritation and inflammation at the joint capsule. There will be an increase of synovial fluid, which causes swelling and pain.
• The muscles around the hip joint become weaker. Therefore, an increase of force occurs with the articular surface.
• Some joint tendons become loose, which makes the joint swing or become more loose and creates abnormal movement.
• The bones around the joint adjust by growing a bone inside the joint, which causes the joint to move less. Because most patients begin to walk less, the bones around the hip joint and around the joint become thinner. Symptoms
1. Pain with a jammed joint
2. If not receiving treatment for hip dysplasia, bone may grow around the joints if the cartilage has completely deteriorated.
3. There may be severe pain when the bones rub against each other and the leg will become shorter.
4. If the pain becomes too severe to stay still, swivel, or stretch the hip joint because the muscles that control the hip joint become weak due to less usage, it might weaken the legs.
Diagnosing hip dysplasia includes history taking, and diagnosing any illnesses by physical check-up, x-ray and other additional diagnosis, like Magnetic Resonance Imaging and CT scan. The objectives of the hip dysplasia treatment are to reduce the pain, prevent fixation, and increase the performance. Preliminary self-prevention methods include weight loss in case of being overweight; avoid using the hip joint, like lifting heavy objects; the use of walker; stretching exercises to prevent fixation of joint by following the treatment method of the doctor; oral medication; and physical therapy. In case of receiving the treatment as mentioned above and still feel pain, another alternative treatment is surgery, which can be done in many ways by considering the severity level and cause of deterioration, including age and knee use.
Treatment by surgery
1. Hip arthroscopy
2. Osteotomy, which is a surgery that swivels the normal articular surface to make contact with each other. It will be used when there is damage in one area and other areas are in normal condition.
3. Total hip replacement to replace the deteriorated cartilage with artificial joint.
4. This treatment is popular with the cartilage of hip socket and femur because the materials that are used to make the artificial hip joint have been developed for an extended useful life.