Hip and Knee

The hip, the knee and the shoulder are the big working joints of the body. When something goes wrong with any of them, the problem can seriously impact your entire body and your ability to perform your normal activities.

Some conditions that affect the hip and knee include:

  • Osteoarthritis of the Hip
  • Osteoarthritis of the Knee

Osteoarthritis (of all types) affects nearly 27 million people in North America. It is estimated that 80% of the population have radiographic evidence of OA by age 65, although only 60% of those will have symptoms.

Joint replacement (arthroplasty) is required to treat severe cases of the hip, knee and shoulder conditions.

Osteoarthritis of the Hip

Osteoarthritis of the hip causes the hip joint to get stiff and inflamed and can progress until resting no longer relieves your pain. Bone spurs might build up at the edges of the joint. When the cartilage wears away completely, bones rub directly against each other, making it very painful to move. You may lose the ability to rotate, flex or extend your hip. If you become less active to avoid the pain, the muscles controlling your joint get weak and you may start to limp.

While you can’t reverse the effects of osteoarthritis, early treatment may help you avoid pain and disability and slow progression of the disease. If you have early stages of osteoarthritis of the hip, the first treatments may include:

  • Resting your hip from overuse
  • Following a physical therapy program of gentle, regular exercise like swimming, water aerobics or cycling to keep your joint functioning and improve its strength and range of motion
  • Using nonsteroidal anti-inflammatory medications like ibuprofen for pain
  • Getting enough sleep each night

In later stages of osteoarthritis, your hip joint hurts when you rest at night or your hip may be severely deformed. Your doctor may recommend total hip replacement surgery or arthroplasty. A two-piece ball and socket will replace your hip joint. This will cure your pain and improve your ability to walk. You may need crutches or a walker for a time after surgery. Rehabilitation is important to restore your hip’s flexibility and to work your muscles back into shape.

Osteoarthritis of the Knee

A normal knee glides smoothly because cartilage covers the ends of the bones that form joints. Osteoarthritis damages this cartilage, progressively wearing it away. The ends of the bones become rough like sandpaper. This damaged cartilage can cause the joint to “stick” or lock and your knee may get painful, stiff and lose range of motion.

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel pain while you’re sitting or lying down.

Symptoms may include:

  • Severe knee pain that limits your everyday activities, including walking, going up and down stairs, and standing up from a chair. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.
  • Moderate or severe knee pain while resting, day or night.
  • Chronic knee inflammation and swelling that doesn’t improve with rest or medications.
  • Knee deformity a bowing in or out of your knee.
  • Knee stiffness inability to bend and straighten your knee.
  • Failure to get pain relief from non-steroidal anti-inflammatory drugs.

Medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis. Their effectiveness varies from person to person and may become less effective for patients with severe arthritis.

If medications, changing your activity level and using walking supports are not effective, you may want to consider knee surgery. Inability to tolerate or complications from pain medications or failure to substantially improve with other treatments such as cortisone injections, physical therapy or other surgeries may suggest a knee operation.

There are two surgical treatments for osteoarthritis of the knee:

  • An osteotomy is surgery that reshapes the shinbone (tibia) or thighbone (femur) to improve your knee’s alignment. The healthy bone and cartilage is realigned to compensate for the damaged tissue. Knee osteotomy surgically repositions the joint, realigning the mechanical axis of the limb away from the diseased area. This lets your knee glide freely and carry weight evenly. Osteotomies may restore knee function and significantly diminish osteoarthritis pain.
  • Total knee replacement surgery is another procedure that can help relieve your pain, correct your leg deformity and help you resume your normal activities. This procedure calls for removing the damaged cartilage and bone and inserting new metal and plastic joint surfaces to restore the alignment and function of your knee.