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Posted by beatle on November 24, 1999 at 23:46:38:

In Reply to: Hip Arthritis posted by Tom on November 23, 1999 at 10:38:34:

: 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.

Anything I say should not be a substitute for advice from your physician. I also have arthritis. I would get a second opinion if you have any doubts as to if this surgery will help you or not. Its my understanding that even with total hip replacement, low impact activities are the only ones that should be done. Apparently the artificial joint wears out with time and revisions need to be done (especially if the person is very active). The person may feel very good after the replacement but the new joint often wears out over a period of years. It wears out quicker with high impact exercise or if the person is overweight.

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