Hip replacement, also known as hip arthroplasty, is a surgical procedure designed to alleviate hip pain by replacing damaged sections of the hip joint with artificial implants. Many people assume this surgery completely eliminates arthritis from the body, but this is a common misconception. While the procedure effectively addresses the hip joint itself, the underlying disease process that causes arthritis or the potential for its development in other areas can persist.
What Hip Replacement Achieves for Arthritis
Hip replacement effectively addresses the debilitating symptoms of arthritis, such as pain, stiffness, and limited mobility. During the procedure, the orthopedic surgeon removes the damaged cartilage and bone from the hip joint, replacing them with prosthetic components typically made from metal, plastic, or ceramic. This replacement of the joint surfaces is crucial because the artificial implant itself cannot develop arthritis.
For individuals with osteoarthritis, often referred to as “wear-and-tear” arthritis, the surgery effectively removes the diseased joint, providing significant pain relief and improved function. However, for those with systemic inflammatory types of arthritis, such as rheumatoid arthritis, the disease process is body-wide and continues even after the hip joint has been replaced.
Arthritis in Other Body Joints
Arthritis can still affect other body joints after a hip replacement due to different factors. Individuals with systemic inflammatory conditions, such as rheumatoid arthritis or psoriatic arthritis, have diseases that impact multiple joints throughout the body. Replacing one hip does not stop the disease from progressing or affecting other areas like the knees, spine, or the other hip. The underlying autoimmune response continues to target healthy joint tissue elsewhere.
Another reason for arthritis in other joints is a compensatory effect from altered biomechanics following surgery. Changes in gait or weight distribution after a hip replacement can place increased stress on adjacent or distant joints. For example, the other hip, knees, or the spine may bear additional load, potentially accelerating the development of osteoarthritis in those areas. This altered loading can lead to new or worsened arthritic symptoms in previously unaffected joints.
Arthritis-Like Pain Near the Replaced Hip
Experiencing pain near a replaced hip that feels like arthritis is possible, even though the artificial joint itself cannot develop the condition. This pain often stems from inflammation in the surrounding soft tissues rather than the implant. Tendons and bursae, which are fluid-filled sacs that cushion joints, can become irritated or inflamed.
Common examples include trochanteric bursitis, which causes pain on the outside of the hip, especially when lying on the affected side or after prolonged walking. Iliopsoas tendinitis, another frequent issue, presents as groin pain, anterior hip pain, or snapping sensations, often exacerbated by hip flexion. Additionally, pain from other areas, such as the spine or knee, can sometimes be referred and felt in the hip region, mimicking arthritic discomfort.
Identifying and Managing New Arthritis
Recognizing the symptoms of new or persistent arthritis is important for timely management. Common signs to watch for include persistent pain, stiffness, swelling, and a reduced range of motion in any joint.
Diagnosis typically involves a comprehensive medical history and physical examination, followed by imaging studies such as X-rays, MRI, CT scans, or ultrasound to visualize joint structures. For inflammatory types of arthritis, blood tests like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) antibodies may be performed to detect inflammation or specific markers. Management strategies vary but often include non-surgical options like medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or disease-modifying antirheumatic drugs (DMARDS) for systemic conditions. Physical therapy, lifestyle modifications including weight management and targeted exercise, and assistive devices can also help alleviate symptoms and improve joint function.