Hip osteoarthritis

Risk factors include age, obesity, gender (under 45 years osteoarthritis is more common in males, over 55 years it is more common in females), systemic disorders, environmental factors, such as jobs which involve abnormal joint loading, and a genetic predisposition. The patient s ethnic group may also be a factor as more hip osteoarthritis is seen in white Europeans than black or Asian populations. 

Conrozier T, Vignon E. Is there evidence to support the inclusion of viscosupplementation in the treatment paradigm for patients with hip osteoarthritis Clin Exp Rheumatol 2005 23 711-716. 

Conrozier T, Berlin P, Mathieu P, Chariot J, BaiUeul F, Treves R, Vignon E, Chevalier X. Intra-articular injections of hylan G-F 20 in patients with symptomatic hip osteoarthritis an open-label, multicentre, pilot study. Clin Exp Rheumatol 2003 21 605-610. 

Van Den Bekerom MPJ, Mylle G, Rys B, Mulier M. Viscosupplementation in symptomatic severe hip osteoarthritis a review of the literature and report on 60 patients. Acta Orthop Belg 2006 72 560-568. 

Qvistgaard E, Christensen R, Torp-Pedersen S, Bliddal H. Intra-articular treatment of hip osteoarthritis a randomized trial of hyaluronic acid, corticosteroid, and isotonic saline. Osteoarthritis Cartilage 2006 14 163-170. 

The triterpenes of R. rugosa have antinociceptive and anti-inflammatory properties in mice and rats. Anti-inflammatory activity was also displayed by a galactolipid isolated from R. canina. Preparations made from the powdered rose hips were effective in reducing the painful symptoms of knee and hip osteoarthritis in human patients. ... 

Osteoarthritis, the most common arthritic disorder, affects some 30 million Americans each year. Caused by daily wear and tear on joints or injury, osteoarthritis is painful and restricts daily activity. It can affect the basal joint of the thumb, as well as the knee, hip, and other joints. 

Hip replacement surgery is now routinely used to relieve pain and restore mobility in patients suffering from osteoarthritis. In this condition the surfaces of bone in contact with each other within the joint become worn and the layer of lubricating cartilage disappears. This makes movement of the joint both difficult and painful. By replacing the hip with an artificial joint patients stop experiencing pain and are once again able to move freely. 

American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee 2000 update. Arthritis Rheum 2000 43 1905-1915. 

Osteoarthritis proves to be a more complex disease than autoimmune disease, with multiple variable manifestations like knee, hip, hand, DIP, elbow, shoulder, and spinal joints OA, which have different risk factors. The etiology of OA is multifactorial with inflammatory, metabolic and mechanical causes. A number of personal and environmental risk factors, such as obesity, occupation, and trauma, may initiate various pathological pathways. OA comprises degeneration of articular cartilage together with changes in subchondral bone of the joint margins and mild intraarticular inflammation. 

A 52-year-old woman with a history of eczema and heavy alcohol use begins taking ibuprofen to control hip and knee pain due to osteoarthritis. Over... 

It is indicated in spasticity due to neurological disorders e.g., multiple sclerosis, chronic myelopathy, degenerative diseases of the spinal cord, cerebrovascular accidents and cerebral palsy painful muscle spasm associated with static and functional disorders of the spine (cervical and lumbar syndromes) painful muscle spasm following surgery e.g., for herniated intervertebral disc or for osteoarthritis of the hip. 

Lloyd, R.S., Costello, F., Eves, M.J., James, I.G., Miller, A.J. The efficacy and tolerability of controlled-release dihydrocodeine tablets and combination dextropropoxyphene/paracetamol tablets in patients with severe osteoarthritis of the hips, Curr. Med. Res. Opin. 1992, 13, 37-48. 

Brief History. B.W., a 75-year-old woman, fell at home and experienced a sudden sharp pain in her left hip. She was unable to walk and was taken to a nearby hospital where x-ray examination showed an impacted fracture of the left hip. The patient was alert and oriented at the time of admission. She had a history of arteriosclerotic cardiovascular disease and diabetes mellitus, but her medical condition was stable. The patient was relatively obese, and a considerable amount of osteoarthritis was present in both hips. Two days after admission, a total hip arthroplasty was performed under general anesthesia. Meperidine (Demerol) was given intramuscularly as a preoperative sedative. General anesthesia was induced by intravenous administration of thiopental (Pentothal) and sustained by inhalation of halothane (Fluothane). The surgery was completed successfully, and physical therapy was initiated at the patient s bedside on the subsequent day. 

Grainger R, Cicuttini FM. Medical management of osteoarthritis of the knee and hip joints. MedJAust. 2004 180 232-236. 

Wegman A, van der Windt D, van Tilder M, et al. Nonsteroidal antiinflammatory drags or acetaminophen for osteoarthritis of the hip or knee A systematic review of evidence and guidelines. J Rheumatol. 2004 31 344-354. 

Indomethacin This NSAID is more potent than aspirin as an antiinflammatory agent, but it is inferior to the salicylates at doses tolerated by rheumatoid arthritic patients. In certain instances, however (for example, with acute gouty arthritis, ankylosing spondylitis, and osteoarthritis of the hip), indomethacin is more effective in relieving inflammation than is aspirin or any of the other NSAIDs. 

Osteoarthritis is a chronic disease which is characterised by pain and stiffness in the joints. It is not simply a disease caused by wear and tear, many factors can be involved. There is a loss of cartilage and a loss of joint space. There may be bony overgrowths at joint margins. The joints most commonly affected are those of the hands, the knees, hips and spine. 

Thus it may be quite ethical to compare a novel analgesic against placebo for 2 weeks in the treatment of osteoarthritis of the hip (with escape analgesics available). It would not be ethical to use a placebo alone as comparator in a 6-month trial of a novel drug in active rheumatoid arthritis, even with escape analgesia. 

Cannon GW, Caldwell JR, Holt P, McLean B, Seidenberg B, Bolognese J, Ehrich E, Mukhopadhyay S, Daniels B. Rofecoxib, a specific inhibitor of cyclooxygenase 2, with clinical efficacy comparable rvith that of diclofenac sodium results of a one-year, randomized, clinical trial in patients with osteoarthritis of the knee and hip. Rofecoxib Phase III Protocol 035 Study Group. Arthritis Rheum 2000 43(5) 978-87. 

Bauer HW, Klasser M, von Hanstein KL, Rolinger H, Schladitz G, Henke HD, Gimbel W, Steinbach K. Oxaceprol is as effective as diclofenac in the therapy of osteoarthritis of the knee and hip. Clin Rheumatol 1999 18(l) 4-9. 

PIncus T, Koch GG, Sokka T, et al. A randomized, double-blind crossover clinical trial of diclofenac versus misoprostol versus acetaminophen in patients with osteoarthritis ofthe knees or hip. Arthritis Rheum 2001 44 1587-98. 

Osteoarthritis of the hips and knees is a frequent complication of obesity. 4,2, Mortality... 

The Health Outcomes Institute has developed and validated several outcome instruments that can be used to 11 evaluate patient outcomes following interventions by pharmacists. These include hypertension/lipids, angina, asthma, chronic obstructive pulmonary disease, chronic sinusitis, hip replacement, hip fracture, depression, low back pain, osteoarthritis, alcohol abuse, stroke, rheumatoid arthritis, and prostatism (Appendix 4). The Health Outcomes Institute is located at 2001 Killebrew Drive, Suite 122, Bloomington, MN 55425 telephone (612) 858-9188. 

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