Conservative Treatment Options for Osteoarthritis of the Hip

Abstract

Osteoarthritis (OA) of the hip is a common musculoskeletal problem. Often, hip pain begins as femoroacetabular impingement (FAI) that later develops into hip OA. Early symptoms of FAI include groin or greater trochanter pain, asymmetrical hip rotation, limited hip flexion, weakness of the hip flexors and abductor muscles, and the presence of pelvic obliquity. Later, symptoms and signs of clinical hip OA appear including stiffness in the hip lasting less than 1 hour, greater limitation of hip motions in all 3 body planes, increased weakness of most of the surrounding hip muscles, and eventually gait deviations. The purpose of this article was to describe the clinical diagnosis of both FAI and moderate hip OA in an attempt to start early conservative management in a patient who if not treated will likely develop hip OA. We emphasize that only by early recognition of FAI or of moderate hip OA will a conservative treatment program have potential for success. The conservative treatment of late hip OA is often ineffective, especially once the hip joint develops significant joint narrowing and other radiologic changes occur.