Hip Arthritis

What is hip arthritis?

Hip arthritis is a condition in which the cartilage cushioning the hip joint gradually wears down, causing the bones to rub against each other. This leads to pain, stiffness, and a reduction in the hip's normal range of movement.

The most common form is osteoarthritis, which develops as cartilage deteriorates over time, though hip arthritis can also result from previous joint damage or underlying conditions. Dr Varun Arora sees and treats patients with hip arthritis at all stages, across Melbourne and regional Victoria.

Symptoms

Common symptoms of hip arthritis include:

Pain in the groin, thigh, or buttock
Stiffness, particularly after rest
A limp or altered walking pattern
Reduced range of motion
Pain that worsens with activity

Causes and risk factors

IMPORTANT TO KNOW

Hip arthritis can develop for a number of reasons, including:

Age-related wear of the joint
Hip shape problems such as hip dysplasia or femoroacetabular impingement
Childhood hip conditions, such as Perthes disease or a slipped upper femoral epiphysis
Previous hip injury or fracture
Loss of blood supply to the ball of the hip (avascular necrosis)
Inflammatory conditions such as rheumatoid arthritis
Genetic predisposition and excess body weight

How is hip arthritis diagnosed?

Diagnosis is usually based on your symptoms, an examination of how your hip moves, and x-rays of the pelvis and hip. X-rays show narrowing of the joint space and bone spurs. An MRI or CT scan is occasionally needed, for example when x-rays are normal or to look at the hip's shape in younger patients.

Pain around the hip doesn't always come from the joint itself. Dr Arora will also consider other causes, including the lower back, trochanteric bursitis, gluteal tendon problems and labral tears.

Treatment options for hip arthritis

Treatment depends on your symptoms, how much the arthritis is affecting your life and the degree of joint damage. Most people start with non-surgical treatment, and many manage well with it for a long time.

Non-surgical treatment

Exercise and education. Strengthening and movement programs, such as GLA:D or a physiotherapist-guided program, are the foundation of arthritis care.
Weight management. Even modest weight loss can reduce load on the hip and improve symptoms.
Activity modification and pacing
Pain relief. Regular simple pain relief and, where suitable, anti-inflammatory medication. Opioids are not recommended for long-term arthritis pain.
Walking aids. A walking stick held in the opposite hand can noticeably reduce hip load.
Joint injections. An image-guided corticosteroid injection can give temporary relief and can also help confirm that pain is coming from the hip joint.

What about PRP, stem cell or gel injections?

Platelet-rich plasma (PRP), stem cell and hyaluronic acid ("gel") injections are widely advertised. Australian guidelines and the Australian Orthopaedic Association note that there isn't good evidence that they help established hip or knee arthritis, and they are not covered by Medicare. Dr Arora is happy to discuss the evidence with you.

Surgical treatment

When non-surgical treatment no longer provides adequate relief, surgery may be considered:

Hip Replacement: The most common and well-established operation for hip arthritis. Dr Arora performs most hip replacements through the direct anterior approach, usually with a bikini incision. Where suitable, he uses 3D planning or robotic assistance.
Hip Resurfacing: An alternative for selected younger, active patients with good bone quality, where the ball of the hip is capped rather than removed.

Hip arthroscopy (keyhole surgery) is not an effective treatment for established hip arthritis. It is used for selected younger patients with impingement or labral tears and little or no arthritis.

When should I see a surgeon?

Consider asking your GP for a referral if hip pain:

Is limiting your walking, work, sleep or the activities you enjoy
Has not improved despite several months of exercise, weight management and medication
Is making you consider whether surgery might be an option

Seeing a surgeon doesn't commit you to an operation. Many patients come for a clear diagnosis and a plan.

YOUR PATH

Hip Replacement

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Anterior Approach Hip Replacement (bikini incision)

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3D Planning & Patient-Specific Instrumentation

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Robotic Hip & Knee Replacement

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Hip Arthritis Frequently Asked Questions

Understanding hip arthritis

Arthritis can't be reversed, but its symptoms can be well managed with the right combination of non-surgical and, where needed, surgical treatment.
Hip arthritis usually progresses, but the speed varies widely. Some people stay stable for years, while others change over months. Symptoms matter more than x-ray changes when deciding on treatment.
The hip and knee share nerve supply, so hip pain is often felt down the thigh and into the knee. Examining both joints helps find the true source.
Both can cause buttock and thigh pain, and many people have both. Groin pain, stiffness and difficulty with socks and shoes point more towards the hip. An examination, x-rays and sometimes a diagnostic injection help tell them apart.
In younger adults, arthritis is often linked to the hip's shape, for example dysplasia or impingement, or to a previous injury or childhood hip condition. These can sometimes be treated before arthritis becomes advanced. See Hip Dysplasia and FAI.
Usually not. X-rays generally show hip arthritis well. MRI is reserved for situations where the diagnosis is unclear.

Living with hip arthritis

Yes, within reason. Exercise is one of the most effective treatments. Mild discomfort that settles within a day is generally fine. Low-impact activities such as swimming, cycling, walking and strength work are ideal.
Yes. Weight loss reduces load on the hip, often improves pain, and lowers the risks of surgery if you need it later.
Regular paracetamol and, if safe for you, anti-inflammatory tablets or gels are commonly used. Check with your GP or pharmacist, particularly if you have kidney, stomach or heart problems. Opioids are not recommended for long-term arthritis pain.
Studies have generally not shown glucosamine, chondroitin or most other supplements to work better than placebo for hip arthritis.

Injections and other treatments

An image-guided injection can give pain relief lasting weeks to months for some people, and it can help confirm the hip as the source of pain. Repeated injections close to the time of surgery are generally avoided because of infection risk.
There is not good scientific evidence that PRP or stem cell injections help established arthritis, and they can be costly. Please discuss them with Dr Arora before committing.
No. Arthroscopy does not help established hip arthritis and can sometimes make symptoms worse. It is reserved for specific problems in hips with little or no arthritis.

Thinking about surgery

Surgery is considered when arthritis is significantly affecting your daily life and non-surgical treatment is no longer enough. It's a decision you make with Dr Arora, based on your symptoms rather than x-rays alone.
There is no strict age limit. Decisions are based on your symptoms, health and goals. See the Hip Replacement FAQs.
For most people, waiting while managing symptoms doesn't affect the result. However, severe deformity, bone loss or major loss of strength and fitness can make surgery and recovery harder, so regular review is sensible.
A way of performing hip replacement through the front of the hip, between muscles. Dr Arora is fellowship-trained in this approach and usually uses a bikini incision. See Anterior Approach Hip Replacement.
Hip replacement suits the large majority of people. Resurfacing is an option for selected younger, active patients with good bone quality. Dr Arora will explain the pros and cons of each for you. See Hip Resurfacing.
Your GP referral, any recent x-rays or scans (images and reports), a list of your medications, and details of treatments you've already tried. See Your Appointment.