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Many people will experience pain in their joints and limbs in the course of their life. These pains can occur after great or unusual physical efforts and will pass by after some time, or after treatment with physiotherapy or massage. Some times the pain will be caused by inflammations in the muscles or tendons and may require medical treatment. Most of us will experience this once or several times during our life – and we know that the pain will pass after some time.
What causes the pain, which make hip replacement a necessary treatment, is wearing down and/or damages to the cartilage of the joint. The hip joint consists of a cavity in the pelvic bone (the acetabulum) and a ball on top of the thigh bone (the femoral head or caput). The femoral head rests and rotates in the acetabular cavity and is held in place by your tendons and muscles. The surface of both the femoral head and the acetabular cavity is
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covered by a smooth layer of cartilage. The cartilage forms two "frictionless" and cushioning layers between the bones and enable us to move around, stretch, bow and so on for many years without problems.
When this layer of cartilage for any reason is worn down or is damaged, this cushioning layer between the bones will vanish and the unprotected bone surfaces will come in contact with each other. This causes friction and may over time lead to swollen joints, inflammations, pain and reduced flexion of the hip. You gradually become immobilized.
There may be several reasons why the cartilages layers of the joint become damaged or is worn down. The most common are:
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Primary Osteoarthrosis. This disease may have various causes. Heritage, age and gender may influence your liability to suffer from osteoarthrosis. Several other diseases and medication may also cause the cartilage to become more fragile and to be worn down. Heavy load (e.g. as a result of obesity) or uneven wear as a result of leg length differences or other physical anomalies may also be causes of osteoarthrosis.
Rheumatoid Arthrosis. This is a chronic disease that may affect young people as well as old. It is caused by rheumatoid arthritis or other rheumatic diseases. Of unknown reasons the immune system erroneously attacks the cartilage, which leads to swelling and inflammations, which at the end will destroy the cartilage of the joint. As the cartilage wears down, the pain will increase and the joint will become more or less stiff.
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Hip Joint Dysplasia. Some children are born with a hip problem called dysplasia. There are several degrees of dysplasia, and the pediatrician will routinely examine the baby for this. Still – not all cases are discovered and treated. As a result, the hip joint will not function perfectly, which in turn may lead to increased wear and restrictions of mobility.
Avascular Necrosis. Avascular necrosis is caused by reduced blood supply to the joint. This may occur as a result of a fracture of the femoral bone or other damages near or to the joint. The cartilage and the bone will not get the nutrition for renewing the cartilage and bone cells when the blood supply to the femoral head is restricted. Avascular necrosis is more common among diabetic patients, people with pulmonary diseases, and among smokers and alcoholics than among other people. High dosages of steroid drugs as cortisone may also cause this disease.
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