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Inflammatory-arthritis-of-hip-1

TREATMENT

Although there is no cure for inflammatory arthritis, there are a number of treatment options that can help prevent joint destruction. Inflammatory arthritis is often treated by a team of healthcare professionals, including rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.

Nonsurgical Treatment

The treatment plan for managing your symptoms will depend upon your inflammatory disease. Most people find that some combination of treatment methods works best.

Non-steroidal anti-inflammatory drugs (NSAIDs). Drugs like naproxen and ibuprofen may relieve pain and help reduce inflammation. NSAIDs are available in both over-the-counter and prescription forms.

Corticosteroids. Medications like prednisone are potent anti-inflammatories. They can be taken by mouth, by injection, or used as creams that are applied directly to the skin.

Disease-modifying antirheumatic drugs (DMARDs). These drugs act on the immune system to help slow the progression of disease. Methotrexate and sulfasalazine are commonly prescribed DMARDs.

Physical therapy. Specific exercises may help increase the range of motion in your hip and strengthen the muscles that support the joint.

In addition, regular, moderate exercise may decrease stiffness and improve endurance. Swimming is a preferred exercise for people with ankylosing spondylitis because spinal motion may be limited.

Assistive devices. Using a cane, walker, long-handled shoehorn, or reacher may make it easier for you to perform the tasks of daily living.

 

Surgical Treatment

If nonsurgical treatments do not sufficiently relieve your pain, your doctor may recommend surgery. The type of surgery performed depends on several factors, including:

  • Your age
  • Condition of the hip joint
  • Which disease is causing your inflammatory arthritis
  • Progression of the disease

The most common surgical procedures performed for inflammatory arthritis of the hip include total hip replacement and synovectomy.

Total hip replacement. Your doctor will remove the damaged cartilage and bone, and then position new metal or plastic joint surfaces to restore the function of your hip. Total hip replacement is often recommended for patients with rheumatoid arthritis or ankylosing spondylitis to relieve pain and improve range of motion.

In total hip replacement, both the head of the femur and the socket are replaced with an artificial device.

Synovectomy. Synovectomy is done to remove part or all of the joint lining (synovium). It may be effective if the disease is limited to the joint lining and has not affected the articular cartilage that covers the bones. Generally, the procedure is used to treat only the early stages of inflammatory arthritis.

Your doctor will discuss the various surgical options with you. Do not hesitate to ask why a specific procedure is being recommended and what outcome you can expect.

Complications. Although complications are possible in any surgery, your doctor will take steps to minimize the risks. The most common complications of surgery include:

  • Infection
  • Excessive bleeding
  • Blood clots
  • Damage to blood vessels or arteries
  • Dislocation (in total hip replacement)
  • Limb length inequality (in total hip replacement)

Your doctor will discuss all the possible complications with you before your surgery.

Recovery. How long it takes to recover and resume your daily activities will depend on several factors, including your general health and the type of surgical procedure you have. Initially, you may need a cane, walker, or crutches to walk. Your doctor may recommend physical therapy to help you regain strength in your hip and to restore range of motion.

Outcomes

Inflammatory arthritis of the hip can cause a wide range of disabling symptoms. Today, new medications may prevent progression of disease and joint destruction. Early treatment can help preserve the hip joint.

In cases that progress to severe joint damage, surgery can relieve your pain, increase motion, and help you get back to enjoying everyday activities. Total hip replacement is one of the most successful operations in all of medicine.

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