At what stage of osteoarthritis are infiltrations ineffective?

Infiltrations are most effective at early and moderate stages (Kellgren-Lawrence stages 1 to 3). At stage 4 (complete joint space narrowing), effectiveness is reduced and hip replacement is generally the best option.

How many hyaluronic acid infiltrations are needed for the hip?

The standard protocol is 1 to 3 injections at one-week intervals. Some recent formulations allow a single injection with prolonged effect. Dr. Bolduc determines the optimal protocol based on the type of osteoarthritis and patient characteristics.

Can I play sports with hip osteoarthritis?

Yes, physical activity is recommended, provided you choose low-impact sports: swimming, cycling, Nordic walking, Pilates. Regular activity strengthens the stabilizing muscles of the hip and reduces pain.

Are ultrasound-guided hip infiltrations painful?

Discomfort is moderate. The needle used for hip infiltration is longer but fine. Local anesthesia and the precision of ultrasound guidance minimize pain. Most patients tolerate the procedure very well.

Hip Osteoarthritis: Non-Surgical Treatments to Relieve Pain

Coxarthrosis: Alternatives to Hip Replacement Surgery

Hip osteoarthritis (coxarthrosis) is a degenerative pathology affecting the articular cartilage. It manifests as progressive pain in the groin, buttock, or anterior thigh, morning stiffness, and limited mobility. Fortunately, numerous therapeutic options can relieve symptoms and delay or even avoid prosthetic surgery.

Conservative Treatments

Physiotherapy and exercises: The cornerstone of treatment. Strengthening exercises for the gluteal muscles, external rotators, and quadriceps improve joint stability. Stretching and proprioceptive training are also essential.

Adapted activities: swimming, stationary cycling, Nordic walking. Avoid high-impact sports (running, jumping).
Weight loss: each kilogram lost reduces the load on the hip by 3 to 4 kilograms during walking.
Walking aids: contralateral cane to reduce load on the painful hip.
Analgesics and NSAIDs: in short courses or as needed.

Ultrasound-Guided Infiltrations

Hip infiltrations are technically complex procedures due to the depth of the joint. Ultrasound guidance is essential to guarantee precision and safety.

Cortisone Infiltration

Rapidly reduces inflammation and pain. Maximum effect at 5-7 days. Duration of 4 to 12 weeks. Ideal for congestive flare-ups. Maximum 3 to 4 infiltrations per year.

Hyaluronic Acid Infiltration (Viscosupplementation)

Hyaluronic acid acts as a lubricant and intra-articular shock absorber. 1 to 3 injections at one-week intervals. Effect lasts 6 to 12 months. Particularly indicated for moderate osteoarthritis (Kellgren-Lawrence stages 2 and 3).

PRP Infiltration

Stimulates cartilage regeneration and reduces inflammation. A single intra-articular injection. Results appear after 4 to 8 weeks. Duration of 12 to 18 months. Promising for early-stage osteoarthritis.