Osteoarthritis is a leading cause of musculoskeletal pain and disability. The most recent Global Burden of Diseases study, published in The Lancet in 2012, found that, of

the musculoskeletal conditions, the burden associated with Cell Cycle inhibitor osteoarthritis is amongst the most rapidly increasing ( Vos et al 2012). Hip osteoarthritis is extremely debilitating for affected individuals. Pain is a dominant symptom, becoming persistent and more limiting as disease progresses. Patients with hip osteoarthritis also report difficulty with functional activities such as walking, driving, stair-climbing, gardening, and housekeeping ( Guccione et al 1994) as well as higher levels of anxiety and depression ( Murphy et al 2012). Work productivity is affected with greater absenteeism, while fatigue and sleep problems are common ( Murphy et al 2011). Furthermore, people with osteoarthritis typically suffer from a range of co-morbid diseases that further increases their likelihood of poor physical function ( Guh et al 2009). Hip osteoarthritis

imposes a substantial economic burden, with most costs related to a range of conservative and surgical treatments, lost productivity, and substantial loss of quality of life (Dibonaventura et al 2011). In particular, rates of costly hip joint replacement surgery for advanced disease are increasing including a shift in the demographic of recipients to younger patients (Australian Orthopaedic Association National Joint Replacement Registry 2012, Ravi et LBH589 ic50 al 2012). Clearly hip osteoarthritis

Rebamipide is associated with considerable individual and societal burden and, given that there is currently no cure for the disease, treatments that reduce symptoms and slow functional decline are needed. The development of hip osteoarthritis results from a combination of local joint-specific factors that increase load across the joint acting in the context of factors that increase systemic susceptibility (Figure 1). Age is a well-established risk factor for hip osteoarthritis as are developmental disorders such as congenital hip dislocation, slipped capital femoral epiphysis, Perthes disease, and hip dysplasia (Harris-Hayes and Royer 2011). More recently, femoroacetabular impingement, which refers to friction between the proximal femur and acetabular rim due to abnormal hip morphology and is seen in younger active individuals, has been implicated as increasing the risk of hip osteoarthritis (Harris-Hayes and Royer 2011). Caucasians appear to have a higher prevalence of hip osteoarthritis compared to Asian, African, and East Indian populations. Albeit based on limited or inconsistent evidence, hip osteoarthritis also appears to be associated with obesity, occupations involving heavy lifting and farming, high volume and intensity of training particularly in impact sports, and leg length discrepancy (Suri et al 2012).