Hip and Knee Arthritis

• Osteoarthritis – also known as wear and tear arthritis, this is caused by damage to the cartilage that cushions the end of the bones. As the cartilage wears away, it can result in bone rubbing against bone, causing severe pain and disability. Painful bony spurs may also develop. Osteoarthritis can affect many different joints in the body, including the hip, knee, ankle and foot.
• Rheumatoid Arthritis – this is an autoimmune condition. The body’s immune system, which normally fights infection, starts to attack healthy joints, as well as organs and tissues throughout the body. It can lead to painful, swollen joints and loss of mobility. Unlike osteoarthritis, which may only affect one joint, rheumatoid arthritis tends to attack the same joints on both sides of the body.
• Post-traumatic Arthritis – this is a form of arthritis that develops following an injury, such as a fracture, ligament tear or severe sprain. It can sometimes develop years after the original injury and shares many of the symptoms of osteoarthritis.
• Childhood hip disease – hip problems during childhood include hip dysplasia where the hip socket fails to form properly or Perthes disease where the ball part of the hip joint is misshapen. These conditions can sometimes lead to hip arthritis later in life.
• Gout – this is a type of arthritis that leads to the formation of small crystals in and around the joints, particularly the toes, ankles, fingers and knees. It results in sudden severe pain and swelling. It is caused by the build-up of uric acid in the blood, which can be linked to obesity, high blood pressure, diabetes, eating certain foods including red meat and seafood, and drinking too much alcohol.

Diagnosis will normally begin with a physical examination during which your symptoms will be assessed. You may also be referred for imaging tests which can help to confirm a suspected diagnosis or rule out other conditions. They can also be used to assess the extent of any damage to joints, which can help to determine the most appropriate course of treatment. Imaging tests might include:

• X-ray
• CT scan
• MRI scan
• Ultrasound scan

Specific conditions may require additional diagnostic tests. For example, to diagnose gout you may be given a joint fluid test or blood test.

Degenerative diseases can lead to debilitating pain and loss of movement and function. A range of different treatments may be recommended, depending on the condition, its severity and the symptoms you are experiencing. Your age and state of health might also influence the treatment you are offered, which might include:

• Painkilling medication and anti-inflammatories to help to manage pain and reduce inflammation.
• Lifestyle changes to prevent further deterioration or to reduce symptoms, wherever possible. This may include weight loss or avoiding certain types of foods or drinks that can trigger symptoms.
• Non-surgical treatments will always be tried initially before more invasive surgical procedures which can carry greater risks. These might include:
  • injections of corticosteroids into the affected joint which can provide rapid and effective pain relief.
  • injections of hyaluronic acid into the affected joint which can act as a lubricant and shock absorber and help the joint to function better.
  • injections of platelet rich plasma (PRP) into the joint which can promote healing and cartilage regeneration
• Surgery – if your condition has deteriorated and is causing severe pain or loss of mobility you may be offered surgery. Depending on the condition you may be able to have arthroscopic (keyhole) surgery or you may be offered open surgery. For the most severe joint damage, you may need joint replacement surgery. The aim will always be to provide maximum pain relief and to provide optimum movement and flexibility.
• Physiotherapy – can be helpful in optimising joint function by maintaining joint flexibility, strengthening muscles and helping condition other nearby joints that may also be affected.