Hip Osteoarthritis (Coxarthrosis): Therapy

General measures

Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day); ≥ 20 glasses of beer/week lead to a significant increase in coxarthrosis and gonarthrosis (knee osteoarthritis); individuals who drank 4 to 6 glasses of wine per week had a lower risk of gonarthrosis
Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program – to relieve the joints!
Inclusion of a physical activity (eg, walking; Tai Chi) for all patients with coxarthrosis or gonarthrosis with mild to moderate symptoms to minimize pain and improve mobility; an additional exercise program can reduce the need for arthroplasty in patients with coxarthrosis by 44% for the previously named group.
An upright posture – while sitting and standing – relieves pressure on the joints.
Avoidance of:
- Overloading of the joints, for example, by competitive and high-performance sports or long-lasting heavy physical loads, for example, in the profession (construction workers, especially floor layers).
- Lack of physical activity, since the cartilage gets its micronutrients from the synovial fluid, it is dependent on the joint being moved
- Incorrect footwear – A resulting foot malposition can lead to wear and tear of the articular cartilage. Frequent wearing of high heels is particularly harmful.

Therapy with chondroprotectants (cartilage protection preparations) – supplements (vital substances) containing glucosamine and chondroitin sulfate are considered suitable chondroprotectants.

Orthopedic aids are of importance for a mechanical load distribution. There are the following options:

In case of defective statics: insoles or shoe elevation; soft heels (buffer heel).
Walking stick, which is used on the healthy side.

Nutritional counseling based on nutritional analysis
Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
- A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
Selection of appropriate food based on the nutritional analysis
See also under “Therapy with micronutrients (vital substances)” – Taking a suitable dietary supplement.
Detailed information on nutritional medicine you will receive from us.

Regular exercise ensures that joint cartilage is well supplied with synovial fluid. In addition, physical activity supports the build-up of bone mass.
Endurance training (cardio training) and strength training (muscle training) and flexibility training.
Strengthening the muscles surrounding the joint can relieve arthritis symptoms.
Cycling, swimming, aqua gymnastics and Nordic walking are joint-friendly sports.
Sports with rapid changes of direction and high pressure loads such as volleyball, handball and badminton are not recommended.
Sports exercises and muscle building programs (individualized strength training).
An additional exercise program may reduce the need for arthroplasty by 44% for patients with coxarthrosis (with mild and moderate symptoms)
Caution: monotonous exercise and overuse (sports, occupation) can damage articular cartilage.
Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
Detailed information on sports medicine you will receive from us.

Physical therapy can help alleviate symptoms. It offers a wide range of treatment methods that support the therapy of osteoarthritis:

Exercise therapy – cycling or swimming
Gait training – gait, posture and coordination training.
Massages
Physiotherapy
Thermotherapy, this consists of heat and cold therapy (cryotherapy):
- Heat therapy in the form of balneotherapy (warm water baths with mineral salts dissolved in it) or electrothermotherapy has analgesic (pain-relieving) effects and improves walking distance and health-related quality of life.
- Cryotherapy is used only in active, inflammatory coxarthrosis.

High-intensity ultrasound (HIU) – The procedure is used for localized, noninvasive delivery of therapeutic compounds (pharmaceuticals) by ultrasound to articular cartilage and subchondral bone. [The procedure is still in testing.]
Magnetic resonance therapy (MRI) (Synonyms: MBST nuclear magnetic resonance therapy, nuclear magnetic resonance therapy, multibiosignal therapy, multi-biosignal therapy, MBST nuclear spin) – treatment method in which the magnetic resonance imaging (MRI; magnetic resonance imaging; short: nuclear spin) known from diagnostics is used therapeutically. The procedure aims at reactivating metabolic processes in the cells, thus enabling the regeneration of defective cartilage and bone tissue.
Pulsed Magnetic Field Therapy (PMT) – physical procedure that usually uses pulsed electromagnetic fields (PEMF) to improve microcirculation and stimulate and regulate cellular and energy balance.

After implantation of an endoprosthetic hip replacement; including gait training.