Osteoarthritis of the hip conservative treatment with type A botulinum toxin

Abstract

The diagnosis of hip OA follows the 1991 American College of Rheumatology (ACR) guidelines and is addressed through history and physical examination, as well laboratory and radiographic examinations. In the algorithm, hip pain is taken into account plus two of the following criteria: 1) erythrocyte sedimentation rate < 20 mm/hour, 2) femoral or acetabular osteophytes and 3) narrowing of the upper, axial and/or medial joint space 7 . OA severity assessment is carried out using the Kellgren and Lawrence radiological scale proposed in 1957, which considers four grades of severity with a progressive increase in joint compromise (Table 1).OA was previously considered a degenerative disease and exclusive to articular cartilage but, currently, it is assumed as a chronic, low-grade inflammatory condition that fully affects the joint 8 . There are three main factors that participate in this process: the