Minimally Invasive Therapies for Osteoarthritic Hip Pain: a Comprehensive Review

Curr Pain Headache Rep. 2020 Jun 6;24(7):37. doi: 10.1007/s11916-020-00874-8.

Abstract

Purpose of review: Osteoarthritis (OA) is a highly prevalent cause of chronic hip pain, affecting 27% of adults aged over 45 years and 42% of adults aged over 75 years. Though OA has traditionally been described as a disorder of "wear-and-tear," recent studies have expanded on this understanding to include a possible inflammatory etiology as well, damage to articular cartilage produces debris in the joint that is phagocytosed by synovial cells which leads to inflammation.

Recent findings: Patients with OA of the hip frequently have decreased quality of life due to pain and limited mobility though additional comorbidities of diabetes, cardiovascular disease, poor sleep quality, and obesity have been correlated. Initial treatment with conservative medical management can provide effective symptomatic relief. Physical therapy and exercise are important components of a multimodal approach to osteoarthritic hip pain. Patients with persistent pain may benefit from minimally invasive therapeutic approaches prior to consideration of undergoing total hip arthroplasty. The objective of this review is to provide an update of current minimally invasive therapies for the treatment of pain stemming from hip osteoarthritis; these include intra-articular injection of medication, regenerative therapies, and radiofrequency ablation.

Keywords: Corticosteroids; Hip osteoarthritis; Hyaluronic acid; Intra-articular injection; Platelet-rich plasma; Radiofrequency ablation; Viscosupplementation.

Publication types

  • Review

MeSH terms

  • Acetylcholine Release Inhibitors / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Bone Marrow Transplantation
  • Botulinum Toxins, Type A / therapeutic use
  • Conservative Treatment
  • Exercise Therapy
  • Femoral Nerve / surgery
  • Glucocorticoids / therapeutic use*
  • Hip Joint / innervation*
  • Humans
  • Hyaluronic Acid / therapeutic use
  • Injections, Intra-Articular
  • Injections, Intramuscular
  • Mesenchymal Stem Cell Transplantation*
  • Obturator Nerve / surgery
  • Osteoarthritis, Hip / therapy*
  • Pain Management / methods*
  • Physical Therapy Modalities
  • Platelet-Rich Plasma*
  • Radiofrequency Ablation*
  • Transplantation, Autologous
  • Treatment Outcome
  • Viscosupplements / therapeutic use

Substances

  • Acetylcholine Release Inhibitors
  • Anti-Inflammatory Agents, Non-Steroidal
  • Glucocorticoids
  • Viscosupplements
  • Hyaluronic Acid
  • Botulinum Toxins, Type A
  • abobotulinumtoxinA