Osteoarthritis in Old-Aged People

Introduction

Osteoarthritis is a form of arthritis that occurs in the weight-bearing bone and joints such as the hip. These usually occur as a person ages. It is also called 'wear-and-tear arthritis.' Hip osteoarthritis can result in pain and stiffness and make it difficult for the person to do everyday activities such as bending, walking, or raising from the chair. This condition worsens with age, so early treatment helps to prevent the worse impact of this condition on life. There is no permanent cure for this condition, but treatment helps manage and reduce the pace at which osteoarthritis worsens.

What Are the Causes of Osteoarthritis?

There is no specific cause of osteoarthritis, but certain causes can increase the risk of osteoarthritis; some are

• Increased age of the person.

• Family history of the same condition.

• Previous hip injury, which has affected the joint.

• There is no proper hip joint formation, such as developmental dysplasia.

What Are the Signs and Symptoms of Osteoarthritis?

The signs and symptoms of this condition develop slowly as the person ages and worsens over time. Some common signs and symptoms are

• Pain: The affected joint or bone causes pain during or after movement. Pain can flare up with vigorous movements. The pain in the groin or thigh can radiate to the buttocks or the knee.

• Stiffness: Joint stiffness is an important symptom that will be more evident after being inactive, walking, or bending.

• Tenderness: The affected joint may be tender when slight pressure is applied upon the joint or near it.

• Loss of Flexibility: The joint cannot be moved freely through its full range of motion due to reduced flexibility.

• Grating Sensation: When used, the joint may have a grating sensation, and a popping or crackling sound can be heard.

• Bone Spurs: Bone spurs are extra bits of bone formed around the joint, which can be sensed as hard lumps. Locking and sticking of the affected joints during movements are caused by loose bits or fragments of cartilage or other tissues interfering with the hip's normal smooth movement. There will be enhanced joint pain with rainy weather.

• Swelling - Swelling can be caused due to inflammation of the soft tissue around the affected joints.

The signs and symptoms can be on and off in the initial stages, related only to the affected joints and particular activity. During this phase, proper rest and avoiding any triggering activity can help to improve the symptoms. As the condition worsens, it becomes difficult for the person to do basic activities like walking, where the signs and symptoms become more severe and persistent. When hip osteoarthritis becomes severe, the pain caused may continue even after the activity is stopped or the person stops walking. When this condition is left untreated and worsens, it will not respond to any pills or injections.

How Is Osteoarthritis Diagnosed?

During the diagnosis of osteoarthritis, a physical examination will be performed, the doctor may enquire about the symptoms and the medical history, and a few diagnostic tests can be recommended. The doctor will see some physical examinations for,

• Pain or tenderness around the hip joint.

• The range of active and passive movements.

• Presences of grating sensation within the joints during movements.

• Occurrence of pain when any pressure is applied to the hip.

• Problem or pain when the person walks.

• Symptoms and signs of injury to the ligaments, joints, and hip tendons.

Some imaging tests recommended by doctors are

1. X-Ray:

X-rays view a clear and detailed image of dense structures like bone. The X-ray of the person affected by arthritis will show images of narrowing of hip joint space, alteration of the bone, and occurrence of bone spurs.

2. Other Imaging Tests:

MRI (magnetic resonance imaging) or CT (computed tomography) are recommended to view the bone's condition and surrounding tissue.

How Can Osteoarthritis Be Treated?

There is no complete cure for osteoarthritis, but early treatment can help to manage the symptoms. Initially, non-surgical treatments are recommended by the doctors; some are

1. Lifestyle Changes: Certain lifestyle alterations can reduce the pace at which the condition progresses; some are

• Reducing the activities that trigger or aggravate osteoarthritis, like climbing stairs.

• Changing from high-impact exercises or activities to low-impact activities can reduce the stress on the hip joint.

• Weight loss can lower the hip joint's pressure and enhance its function.

2. Physical Exercise:

• Some physical activities or exercises can improve the strength of the joints or muscles in the legs and hips. Doctors recommend regular physical activity to prevent any injury to the hip joint.

3. Assisted Devices:

• For walking, assisted devices like a cane, crutches, etc., can enhance movement and independence. These devices can help reduce the risk of injury and pain.

4. Medication:

• If the pain caused in the joint is relieved or reduced with the help of other non-surgical methods, the doctor can recommend some medication along with these activities, which helps to reduce pain. Some medications recommended are NSAIDs (nonsteroidal anti-inflammatory drugs), corticosteroids, or acetaminophen.

5. Surgery:

Surgical Treatments to Manage Osteoarthritis Are:

• Complete Hip Replacement:

The doctor will replace the damaged portion of the hip joint with metal, ceramic, or plastic hip joint surfaces, which helps to restore the hip joint function.

• Hip Resurfacing:

In this procedure, the hip socket, the acetabulum, is replaced with a metal shell, and the head of the femur is not eliminated but is covered with a smooth metal covering.

• Osteotomy:

The thigh bone's head or the socket is eliminated and realigned to reduce the pressure over the hip joint. This is a rare procedure done to manage osteoarthritis.

Post any osteoarthritis-related surgery, there should be some healing period provided to the person, depending on the form of surgery performed. In many cases, surgery helps to relieve pain and helps to perform day-to-day activities without any hindrance.

What Are the Complications Associated With The Surgical Procedure Done to Manage Osteoarthritis?

Some complications are

• Infection.

• Severe bleeding.

• Blood clots.

• Hip dislocation.

• Inequality of limb lengthening.

• Damaged blood vessels.

Conclusion

Osteoarthritis is a condition of arthritis that can affect any joint, especially the hip joint. This condition occurs and worsens as a person ages. There is no permanent cure for this condition, but it can be managed with the help of various non-surgical and surgical treatment modalities. This condition needs treatment initially, or it worsens as the person ages.