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Posted by Gramps on November 25, 1999 at 20:33:09:

In Reply to: Re: Hip Arthritis posted by Kristie on November 24, 1999 at 12:47:19:

: : At 39 years old I have gotten the following diagnosis. I am very active but have problems playing tennis and basketball. I play golf, cycle, work out with weights and ski.

: : My diagnosis is that "both my hip joints show osteoarthritic changes, the degernarative process on the left side is clearly advanced. The pathogenesis of the degeneration is a functional mismatch between the femoral head-neck area and the anterior acetabular rim. This impingement produces a degenerative rupture of the labrum followed by an abrasion of the acetabular cartilage. This happens in flexion, in flexion-internal rotation and flexion-adduction."

: : "The hip morphology shows two etiological factors. One is a very flat contour between the anterior head and neck area without a clear offset. This leads to impingement very early during flexion. When flexion continues this area is squeezed into the acetabulum where it rips off the cartilage. The second factor is a relative retroversion of my acetabulum producing an anterior overcoverage. With this again the anterior clearance of the hips is reduced, or in other words the impingement starts earlier with flexion and with the associated movements."

: : "There is no question that with the background of such a hip morphology my sportive activities have accelerated the cartilage destruction. While the right hip seems to be stationary, the left has deteriorated within the observation time. This is all very basic joint mechanism and a rational treatment can only consist in a mechanical improvement. But this makes only sense as long as the joint cartilage is still more or less intact. In the left hip the deterioration of the acetabular cartilage is already too advanced to give any mechanical improvement even an acceptable prognosis."

: : At this point orthopaedic surgeons have recommended an arthoscopic cleaning out of the hip joint area and they clain that this should increase mobility and lessen pain. Please give your opinions of weather this would work, if anyone thinks this is the first correct step to take and does anyone know of anyone else that has had this procedure and then played tennis or a similar moderatly impact sport after this procedure. Please offer your opinions back.

: Tom--
: I have a similar problem. I am an active, healthy 46 yr old. I learned a year ago, when I went to the doctor's because my left hip was hurting alot and the ski season had started and I had enough pain that I knew I could not ski. They took x-rays, and I learned that both hips are fully arthritic and degenerated--teh left was bone-on-bone; the right about 25% gone, and arthritis was quite active. It turns out that I have shallow hip sockets, and the joint has mechanically worn out and arthritis has set in attacking the cartilage that has squeezed out from the joint.
: So, I started the NSAIDS treatment; tried many different kinds over last year, including Celebrex, but my stomach/intestines could not handle any--now I am so careful about what I take. The NSAIDS helped greatly, but were tearing up my insides and making me feel sick all the time.
: So, even though they like to hold off hip replacement as long as possible, I was going to plan to do it soon. I hear that once the hips are replaced, arthritis problems are essentially gone. And it is a well-refined operation, but still major surgery. (I've never had surgery) We are trying one more therapy--I got a cortisone shot in the worst hip, and I am amazed at the results. It has been about 4 weeks now, and I am still walking on air. The cortisone took most of the pain and stiffness away--amazingly from both sides. There are still some uncomfortable arthritic feelings, but not the incredible pain. We are hoping this will last several months (6 to 9), and can delay the surgery for me for a few years.
: However, I almost feel like let's just do the surgery. I want to be healthy again.
: For your case, it may help to go in and clean out arthroscopically the joint. I know of several people who have had that done in their shoulder and have had great results. I don't know about the hip--and I'd sure get a second opinion if I were you. They can probably clean it out some, but you will probably still be facing hip replacement anyway. But if you can get good relief for a period of time, it would sure be worth it. I would think you would still have to be careful after the cleaning, and your lifestyle may still be hampered.
: This cortisone shot is the first time in a year I have had real relief without feeling sick from NSAIDS. It's great and if it lasts for 6 months or so, it will be worth it. If not, I'm going for hip replacement, which is inevitable anyway.
: Good luck to you,
: Kristie

Tom and Kristie,

I feel bad that you two have problems at such a young age. I started a running program 5 years ago when I was 52 and was diagnosed with hip arthritis 6 weeks ago at 57 after 9 marathons. I used Advil everyday and now I've read where nsaid's may contribute to cartilage destruction. I now have nearly as many books on arthritis as I do on running and will try every remedy before doing the hip replacement . I know I also have arthritis in my neck and feel I have to find a cure before replacing all my arthritic parts. Keep posting with things you've tried and how it worked for you. Good luck,Gramps



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