Hip Osteoarthritis: Etiopathogenesis and Implications for Management

Abstract

Highly prevalent among the elderly, hip osteoarthritis (OA) carries a heavy burden of disease. Guidelines for the management of hip OA are often extrapolated from knee OA research, despite clear differences in the etiopathogenesis and response to treatments of OA at these sites. We propose that hip OA requires specific attention separate from other OA phenotypes. Our understanding of the etiopathogenesis of hip OA has seen significant advance over the last 15 years, since Ganz and colleagues proposed femoroacetabular impingement (FAI) as an important etiological factor. This narrative review summarizes the current understanding of the etiopathogenesis of hip OA and identifies areas requiring further research. Therapeutic approaches for hip OA are considered in light of the condition’s etiopathogenesis. The evidence for currently adopted management strategies is considered, especially those approaches that may have disease-modifying potential. We propose that shifting the focus of hip OA research and public health intervention to primary prevention and early detection may greatly improve the current management paradigm.

Prevalence of potentially serious drug–drug interactions among South African elderly private health sector patients using the Mimica Matanović/Vlahović-Palčevski protocol

“…On the other hand, the longevity of older adults is associated with musculoskeletal disorders that include osteoarthritis, rheumatoid arthritis and osteoporosis and low back pain. [43][44][45] NSAIDs are effective in controlling pain and stiffness and are often prescribed on a long-term basis for patients with chronic pain. [46,47] Although the prevalence of rheumatoid arthritis in SA for adults aged ≥65 years is relatively low at 2.5% in urban settings and 0.07% in rural settings, that for osteoarthritis is 55.1% in urban settings and ranges from 29.5% to 82.4% in rural settings.…”

Development of a prediction model for future risk of radiographic hip osteoarthritis

“…In the current study, we focus on prediction of incident HOA. A recent review highlighted the fact that HOA requires specific attention separate from other OA phenotypes, since its etiology is different from knee OA 6 . Surprisingly very little prospective data on HOA are available, since the majority of risk factor assessment has been done on cross-sectional data.…”

The effect of 4 months exercise training on systemic biomarkers of cartilage and bone turnover in hip osteoarthritis patients

“…Osteoarthritis (OA) is a prevalent degenerative disease of the joints characterized by progressive deterioration of the articular cartilage and subsequent structural and functional changes in the entire joint, eventually causing pain and physical disability . Exercise therapy, for example a combination of strength, aerobic, and flexibility training, is recommended as a first‐line treatment to reduce pain and improve physical function in patients with hip OA .…”