What types of treatment are available for hip arthritis?

It does not always have to be an artificial hip straight away. If possible, we at Schön Klinik treat or patients with conservative measures initially – i.e. without an operation. Top priority is always the treatment of pain. With the help of a combination of medications to alleviate pain and inflammation, general freedom from pain and a regression in inflammatory values can be achieved in the joint.

However if the arthritis in the hip has already progressed too far so that the joint is considerably damaged or even destroyed, then an operation is recommended. Either the joint itself can be repaired or exchanged for an artifical one. Nowadays there are many individual solutions available.

Physiotherapy for treating malpositions and gaining strength.

Arthritis of the hip is not synonymous with a joint replacement: Also a therapy/exercise pool can reduce pain and ease restricted mobility.

Once acute pain has been relieved with medication, specific physiotherapy can support the healing process. Shortened tendons and muscles because of avoidance postures and malpositioning of the hip can be stretched and the whole musculature strengthened by specific measures. Electrotherapy, the exercise pool and also X-ray irradiation also have a positive effect on the course of arthritis. Products that stimulate cartilage formation may also ease symptoms in individual cases.

„Even without an operation many options are also available for treating arthritis of the hip&Idquo;,according to Prof. Dr. Pavel Dufek, Consultant Orthopaedist in the Schön Klinik Neustadt. „Through specific physiotherapy we can achieve freedom from pain or at the least alleviation of pain for many patients with arthritis in the initial stages, even after treatment with pain relievers.&Idquo;

Realignment operation for arthritis of the hip.

So that the femoral head sits properly in the acetabulum again, any malpositioning must be corrected.

For persistent pain or rapidly progressive arthritis of the hip, an operation should be given consideration. „the deciding criterion for the right point in time for surgery is always the patient's quality of life&Idquo; and Dr. Prof. Dr. Pavel Dufek knows this from numerous discussions with patients.  „If the patient's mobility is severely reduced because of wear and tear to a joint and pain is virtually intolerable and conservative measures have brought no improvement, then certainly the right point in time has arrived for an operation.&Idquo;

A realignment operation corrects the shape of the joint: The joint shape/position is examined and adjusted accordingly – in the same way as an out-of-round tyre is balanced. Therefore progressive arthritis can be halted by severe abrasion. Also the removal of protruding bony growths can improve arthritic symptoms and so reduce pain.

Joint replacement for arthritis of the hip.

If the hip joint is severely damaged, a total endoprosthesis (TEP) can be used. In this case the acetabulum and femoral head are replaced with a prosthesis.

If the joint is already considerably damaged because of arthritis or even destroyed, then an artificial hip joint is recommended. Physicians speak of an endoprosthesis of the hip joint/artificial hip joint replacement. Either part or all of the destroyed hip joint itself is exchanged for an artificial joint. The artificial joint attempts to duplicate the function and structure of the hip joint itself as well as possible.

Depending on the extent of the arthritis, the bone quality and in each case bone structure, we choose the best possible implant prior to the operation in consultation with our patients. This is because just as the body and bone structure of each person is individual, so are the models offered by the manufacturers equally as individual: Men and women's hips differ in size and shape. The age of our patients, their gender, bone density, weight and, last but not least, the activities of daily living also play a role in this decision.

Surface replacement or cap endoprostheses.

Hip implant with a surface replacement: only the damaged joint surface has been replaced.

Here, only the damaged joint surfaces are replaced by the implant. Therefore a lot of the bone can be preserved during implantation. Any possible exchange of material after 10 to 15 years is therefore easier. In addition this prosthesis allows a greater range of movement: These joints seldom dislocate if subject to major contorsion.

• Requirement: The preference is for surface or cap endoprostheses if the initial anatomical conditions are normal. I.e. no destruction over a large area should have taken place.
• Disadvantage: For patients with nickel, cobalt and/or chromium allergies, these prostheses are not suitable because of the implant alloys.

Standard shaft hip endoprostheses.

This hip implant is also implanted using surgical techniques that preserve the tissue. The rough titanium surface grows together well with the body's own bone and is therefore stable in the longer term.

• Advantage: The bearing surfaces of the femoral head and acetabulum can be composed from different optinal combinations to the advantage of our patient (plastic-metal, plastic-ceramic, ceramic-ceramic, metal-ceramic).
• What is also advantageous: Titanium alloys are very well tolerated by the surrounding tissue, promote bone growth and are safe to use in most cases, even in patients with allergies to metal.