Hip osteoarthritis refers to a degenerative disease of the hip joint that occurs between the femoral head and acetabulum, resulting in significant musculoskeletal pain and reduction in normal range of movement.
While most common in the older population, hip osteoarthritis can represent a considerable economic burden in the form of increased healthcare costs to pursue a range of conservative and surgical treatment options.
Among the many risk factors associated with the onset of condition, clinicians also need to investigate joint-specific factors that can place excessive load across the joint; this can include the prevalence of developmental disorders such as hip dysplasia or biomechanical disturbances such as a hyperpronated foot.
As mentioned by Kim Bennell, from the Department of Physiotherapy at the University of Melbourne, femoroacetabular impingement disorder, that arises out of friction between the proximal femur and acetabular rim, can also increase the risk of hip osteoarthritis.
Diagnosing the condition involves a thorough analysis of patient history in addition to a detailed physical examination of the affected region. Radiographic imaging is helpful in detecting moderate-to-severe hip osteoarthritis, particularly subchondral sclerosis, bone cysts and osteophytes.
Dr Tony Rocklin, who specialises in orthopaedic and sports medicine with an emphasis on treating hip pathologies, states that “combining patient-specific manual therapy with specific therapeutic exercises shows the greatest promise for positive patient outcomes in the treatment of hip osteoarthritis prior to surgical intervention”.
With an improvement in mobility and reduction in pain, the patient is in a better position to perform strength-building exercises to further improve physical movement and enhance overall quality of life.
However, in order to prevent relapses, it becomes necessary to address the biomechanical discrepancies that can increase the risk of an individual developing osteoarthritis of the hip joint; a hyperpronated foot, for instance, induces excessive medial femoral rotation in the lower extremity leading to changes in the pelvis, spine and sacroiliac joints.
The abnormal hip biomechanics resulting from these changes can be managed with the use of customised foot orthotics such as MASS4D® that support the foot in its optimal posture to minimise compensatory movements of the lower extremity and to reduce stress on the affected hip.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.