In the later stages of osteoarthritis of the hip joint there are two main sources of incapacity—the pain on movement and weight bearing, and the stiffness of the joint. Which of these elements of the disability is the more incapacitating? There can be no doubt that pain is the dominant factor. Patients with completely stiff hips and no pain have extraordinarily little disability. On the other hand, patients with one-third or one-half normal movement may be unable to walk 100 yards. owing to pain. In treatment, therefore, abolition of pain must be the primary consideration.
Arthroplasty of the hip can usually be relied on to increase the motion of the joint, but it cannot be relied on to relieve pain. There may be some improvement, but neither by arthroplasty nor by osteotomy can one promise complete and permanent relief; one cannot promise the ability to walk 5 or 10 miles
WATSON-JONES R. ARTHRODESIS OF THE OSTEOARTHRITIC HIP. JAMA. 1938;110(4):278–280. doi:10.1001/jama.1938.02790040032008
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