1. Hip Arthritis:

The analysis of Hip arthritis needs to evocate the Hip Anatomy, the definition of Hip Arthritis and the origin of Hip arthritis:

Hip Anatomiy

2. Hip Anatomy:

Drawing top: the femora head which represents the top of the femur has the shape of a sphere which comes to be articulated in a concave cavity: the acetabulum.

Some parameters make it possible to define the hip:

  • The angle CC'D or cervico-diaphysaire angle of the femur whose normal is around 130°; makes it possible to define the coxa-valga of which angle CC'D is raised (drawing in top on the right) and the coxa-vara of which angle is reduced (drawing in bottom on the right);
  • Angle HTE or angle of inclination of the acetabulum roof;
  • Angle VCE or lens field of the femoral head.

These parameters are significant to consider before the installation of the prosthesis.

3. Hip Arthritis:

It concerns the damaged cartilage on the two parts of the hip joint: The hip socket or acetabulum and the ball or femoral head; it associates osseous lesions consisting of the formation of osteophyts represented by osseous fragments which surround the articulation.
You can add the phenomena of osteosclerosis characterized by the degradation of the forming bone of the gaps (or cavities).

4. Origin of Hip Arthritis:

The hip arthritis is a frequent affection which touches approximately 4% of the people between 40 and 70 years. It is more often secondary than primitive.

4.a. Secondary arthritis:

4.a.1. Congenital

It is the consequence of architectural deformity called dysplasia which is generated by a disorder of the development of the bone, several dysplasia are described:

  • Acetabulum dysplasia: insufficiency of development of the high part of the acetabulum;
  • Femoral dysplasia: coxa-valga or coxa-vara.


Before the total hip replacement


After the total hip replacement

4.a.2. Ostéocartilaginus lesions

  • The disease of Paget which is a metabolic disease (biochemical disorder);
  • The ostéonécrosis of the femoral head (OTF) which is the consequence of a bad arterial irrigation of the femoral head.

4.a.3. Fractures :

The traumatisms can generate one necrosis head (by loss of irrigation) or a lysis of the cartilage.

4.a.4. The inflammatory or infectious arthritis:

(classifications of Sèze, of Lequesne in 1962...)

4.b. Primitive arthritis:

The arthritis is known as a primitive one when there is no basic cause on such a metabolic disease or such a deformation of the femur or acetabulum. Clinically, it appears by mechanical pains and a limitation of the passive movements of the hip.



* 4.a.2.2 Example of the osteonecrosis femoral head:

  • It concerns young person, on one side at the beginning, it can touch both sides in more than 50% of the cases.
  • Causes: ischaemia (defect of irrigation) of the femoral head, origin:
    • "Macrovasculaire", post traumatic;
    • "Microvasculaire":
      • either by lubricating embolism (hypercorticism, alcoholism, hyperlipidemia),
      • or by gas embolism (the plunger, bends),
      • or by cytotoxicity (radiotherapy, chemotherapy).

It is only in this cause of osteoarthritis that one can be brought to prescribe a MRI which will show characteristic images:

  • erosions, ulcerations of the cartilage
  • thinning focused of the cartilage of encrusting
  • pinching of the line space
  • lesion associated with the intra-articular acetabulum pad
  • osteophytes
  • cavities
  • articular liquid
  • reactionnal synovitis
  • secondary chondromatosis

Exemple of secondary arthritis



IRM pictures



Total hip replacement