Treatment of hip osteoarthritis

When hip osteoarthritis occurs, it will cause various adverse effects on the patient's life and work. To treat the problem, we must pay attention to some lifestyle methods, such as losing weight, doing some appropriate aerobic exercise, and also pay attention to taking some drug therapies.

1. General treatment

It includes patient health education, self-training, weight loss, aerobic exercises, joint range of motion training, muscle strength training, use of walking aids, wedge walking insoles for genu varum, occupational therapy and joint protection, auxiliary facilities for daily life, etc.

2. Medication

(1) Sodium hyaluronate is the main component of synovial fluid in the joint cavity and one of the components of cartilage matrix. It plays a lubricating role in the joint and reduces friction between tissues. After injection into the joint cavity, it can significantly improve the inflammatory response of synovial tissue, enhance the viscosity and lubricating function of synovial fluid, protect articular cartilage, relieve pain, and increase joint mobility. It is usually injected into the joint, 25 mg at a time, once a week for 5 consecutive weeks, and strict aseptic operation is required.

(2) Glucosamine is the most important monosaccharide that constitutes aminoglycans and proteoglycans in the matrix of articular cartilage. Normal people can synthesize aminoglycans through the amination of glucose. However, in patients with osteoarthritis, the synthesis of aminoglycans in the chondrocytes is blocked or insufficient, resulting in the softening and loss of elasticity of the cartilage matrix, the destruction of the collagen fiber structure, and the increase of cavities on the cartilage surface, which causes bone wear and damage. Glucosamine sulfate can block the pathogenesis of osteoarthritis, promote chondrocytes to synthesize proteoglycans with normal structure, and inhibit the production of enzymes that damage tissue and cartilage (such as collagenase and phospholipase A2), reduce damage to chondrocytes, improve joint movement, relieve joint pain, and delay the course of osteoarthritis. Glucosamine sulfate can also supplement the body with sulfate necessary for the synthesis of amino polysaccharides. The daily oral dose of glucosamine sulfate is 1500 mg, preferably taken with meals.

(3) Non-steroidal analgesics and anti-inflammatory drugs can inhibit the synthesis of cyclooxygenase and prostaglandins, counteract inflammatory responses, and relieve joint edema and pain. You can choose ibuprofen, glucosamine, or nimesulide.

3. Surgery

If the symptoms of hip arthritis are very severe, drug treatment is ineffective, and it affects the patient's daily life, surgical intervention should be considered. However, joint replacement surgery has certain short-term and long-term complications, such as loosening and wear of components, and bone dissolution. These complications cannot be completely resolved at present. The effect of artificial joint replacement is closely related to factors such as the length of operation, the physician's experience, the patient's preoperative physical condition, perioperative management and rehabilitation training. Therefore, artificial joint replacement surgery needs to be performed with caution.