Viscosupplementation in symptomatic severe hip osteoarthritis: A review of the literature and report on 60 patients

Osteoarthritis of the hip is a frequent joint disorder in adults aged 50 years and older. The management focuses on pain reduction, by means of non-steroidal anti-inflammatory drugs and analgesics, physical therapy and weight reduction. When these treatments fail, total hip replacement can be considered. Viscosupplementation is a local therapeutic approach with the objective to decrease pain and to improve joint mobility. The treatment consists of injecting hyaluronic acid or hyaluronate derivatives intra-articularly. Although this approach is frequently used in young sportive adults to avoid knee surgery, its use in the severe osteoarthritic hip is less well documented. Moreover the injection of the hip joint is more difficult than injection of the knee joint, and on another hand the general condition of the patients is often already compromised. In this article we present a literature review on the subject and report the results in 60 patients who received intraarticular viscosupplementation of the hip with the objective to delay total hip replacement surgery.