Hip Osteoarthritis

Abstract

Hip osteoarthritis is a common presenting pathology in orthopedic practice, with 88 per 100,000 presenting with symptomatic disease on a yearly basis. Risk factors for hip osteoarthritis are considered “modifiable” and “non-modifiable.” Modifiable risk factors include muscle weakness, heavy physical stress, and high impact athletics. Non-modifiable factors include gender (females more often than males), increased age, and developmental/acquired deformities such as hip dysplasia, slipped femoral capital epiphysis, and Legg-Calve-Perthes disease. There are classic radiographic findings for hip osteoarthritis and management ranges from conservative (physical therapy, scheduled NSAID use, and weight loss) to operative intervention (total hip arthroplasty).

Define osteoarthritis.	A pathologic, non-reversible condition characterized by destruction of articular cartilage
Describe a physical exam for a patient with hip OA.	Overweight body habitus, potential leg length discrepancy, lack of full extension or flexion in passive ROM, catching/clicking
Name four radiographic findings with OA.	1. Subchondral cysts 2. Subchondral sclerosis 3. Osteophyte formation 4. Joint space narrowing
What is the conservative treatment for hip OA?	Physical therapy, scheduled anti-inflammatories, weight loss
What is the eponym for the direct anterior approach to the hip?	Smith-Petersen
What is the eponym for the posterior approach to the hip?	Southern/Moore
What is the interval for the direct anterior approach to the hip?	Superficial: TFL/Sartorius Deep: Rectus femoris/gluteus medius
What is a major danger in the direct anterior approach to the hip?	Lateral femoral cutaneous nerve
What is a major danger in the direct posterior approach to the hip?	Sciatic nerve
What is the classic position of posterior hip dislocations?	Flexion, adduction, and internal rotation
What is the classic position for anterior dislocation of the hip?	Extension, abduction, and external rotation