Hip osteoarthritis (also called degenerative joint disease or degenerative arthritis) is a condition characterized by a rupture of hip cartilage, which causes pain, swelling, and difficulty in moving this joint. This disease gets worse with time, and it usually affects the bones. It is a problem within the joint.
The exact cause of hip osteoarthritis is unknown; however, experts have developed some risk factors such as advanced age (by decreased elasticity of hip), heredity of arthritis or other bone diseases, trauma or injury of joint, female gender, and excess weight.
On the other hand, bursitis is defined as the inflammation of a “bursa” (fluid-filled sac present around the joints) which is a cushion that lubricates the joint during movement, avoiding the tension between tendons, muscles, and bones. It is a problem outside of the joint.
Bursitis has many causes, including trauma or injuries (especially when the patient develops deep bruising), overuse of hip joint, or as consequence of other conditions such as inflammatory arthritic disease and infection.
In both cases the symptoms are similar, including: hip pain and decreased range of motion (that can affect daily activities). However, these symptoms in osteoarthritis are present from the start and get worse over time, making the hip stiff and inflexible, especially in the mornings; while in bursitis, these symptoms tend to start sharply, especially after prolonged inactivity (like sleeping) or repetitive activity (like jogging or climbing stairs).
A doctor visit is recommended when the patient experiences hip pain frequently, this way the physician can make a diagnosis and can determine the best treatment. Most primary care physicians can make a correct diagnosis and treatment, and only refer the patient to a specialist when the severity of the disease requires it.
But, is hip replacement surgery needed? Fortunately, hip bursitis can be treated in most cases with non-surgical options, like ice therapy, painkillers and anti-inflammatory drugs, and physiotherapy. In severe cases corticosteroid injections can be indicated, and only in treatment resistant cases the physician recommends a hip replacement surgery.
Hip osteoarthritis can be treated the same way as bursitis, when the disease is “active” the patient has a lot of pain and stiffness, so he/she needs to go to emergency care so the symptoms can be treated. Usually, painkillers and anti-inflammatory drugs are indicated, such as topical analgesics, physiotherapy, steroids and hyaluronic acid injections, and when the patient does not or no longer responds to non-surgical therapies, hip replacement surgery.
Likewise, there are different types of surgery for the hip joint, arthroscopic surgery, osteotomy, – only some patients require an arthroplasty (hip replacement surgery). The ideal candidates are those patients with severe joint damage, extreme pain, and/or very restricted mobility.