What Are the Causes of Osteoarthritis in the Hips?
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Prior Hip Injuries
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Hips that have suffered severe physical trauma are much more likely to develop hip osteoarthritis. Depending on the type of trauma sustained, whether labral tears, severe dislocations or damage to the cartilage lining the hip socket, structural abnormalities of the hip that result from injury can result in altered hip biomechanics and function. This in turn tends to increase stress loading and friction on the hip joint cartilage, a condition that accelerates cartilage breakdown, leading to osteoarthritis.
Congenital Malformations
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Many hip problems actually develop during infancy, when skeletal bones are still soft and extremely fragile. Congenital malformations of the hips can lead to osteoarthritis later in life. Oddly shaped femoral heads, abnormal neck/shaft angles, and loose or abnormal hip sockets are common congenital abnormalities that can predispose hips to developing osteoarthritis later in life. The degree of abnormality seems to be the key in predicting whether hip osteoarthritis will develop. Severe hip abnormalities almost always result in osteoarthritis in the hip.
Hip Fractures
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Hip fractures, especially severe breaks that result in bone displacement, oftentimes presage osteoarthritis. Hip fractures almost always result in some type of long-lasting alignment problem and failure to fully heal. One severe fracture creates many smaller ruptures, which cannot align perfectly with the other fractured ends to heal properly. This creates a large area of bony discontinuity, which changes the way that force is transmitted through the hip joint. This altered hip biomechanical profile increases stress and load on the hip joint, which heightens the risk of hip osteoarthritis.
Hip Dysplasia
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Hip dysplasia is a condition whereby the hip joint does not fit into the hip socket correctly. A dysplatic hip can be caused by a shallow hip socket, or by a socket that does not provide adequate coverage for the femoral head. Dysplasia also can be caused by a femoral head that is abnormally angled or shaped, leading to areas of the head remaining uncovered by the hip socket. The development of osteoarthritis is a major risk factor for hip dysplasia due to the fact that a dysplatic hip experiences altered biomechanics and abnormal stress loading throughout its main weight bearing areas, which increases the level of wear and tear on the joint cartilage, which in turn increases the risk of osteoarthritis.
Slipped Capital Femoral Epiphysis
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Slipped capital femoral epiphysis, or SCFE, is a common adolescent hip disorder that results when the femoral head slips along the epiphysis, which is the growth plate of the upper femur, and becomes displaced relative to the leg bone. Surgery is usually required. Over the course of many years, the residual hip deformity, which causes altered hip biomechanics and function, increases stress loading on the hip joint cartilage, which typically progresses into osteoarthritis.
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