• The hip joint is a ball and socket joint
• There is a layer of cartilage covering the ball and a layer of cartilage lining the socket
• Hip arthritis is where this cartilage wears away, eventually exposing bare bone
• Arthritis in the hip causes pain and stiffness
• The pain can be felt in the hip, groin, thigh or even in the knee
• Early arthritis may respond to painkillers, physiotherapy, exercise or hip injections
• Advanced arthritis is treated by hip replacement surgery
• Hip replacement surgery gives excellent results for pain relief and restoration of function

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What is Hip Arthritis?

Arthritis of the hip is a painful condition, where the cartilage in the hip joint wears away, leaving bone rubbing on bone within the joint. The symptoms are normally an aching or burning pain within the joint, with stiffness. The pain is often felt in the groin or down the front of the thigh (referred pain). Arthritis of the hip can even sometimes cause pain to be felt in the region of the knee.

Sometimes there may also be cartilage tears or loose pieces of cartilage or bone within the joint, and these may cause sudden sharp pains, locking (when the hip becomes fixed) or giving way of the hip.

In severe arthritis, the leg can become slightly shortened, with the hip joint becoming severely stiff. Walking becomes painful and daily activities such as reaching down to put on socks or getting into a car can become increasingly difficult.

Normal Hip X-ray. Note the preserved gap between the femoral head (ball) and the acetabulum (socket).

Hip X-ray showing advanced arthritis. Note that the gap between the head and acetabulum has disappeared, and the bone is collapsing and eroding away.

When you come to clinic

When you come to clinic your appointment with your consultant will involve your surgeon asking you about the symptoms you experience in your hip. The surgeon will then examine your hip.  X-rays, and if required, an MRI scan of your hip will be requested. The assessment of your symptoms and examination findings are correlated with the X-ray and MRI findings. A specific treatment plan is discussed with you. This is because many people with radiological features of osteoarthritis do not necessarily have significant clinical symptoms.

Non surgical treatment of early hip arthritis include:

• Doing nothing!
• Education and lifestyle aids
• Walking aids
• Glucosamine and/or chondroitin sulphate tablets
• Simple painkillers
• Anti-inflammatories
• Physiotherapy

Moderate exercise may improve pain and muscle function, and may slow down disease progression. Other benefits include improvement in body weight, cardiovascular fitness and mood.

It is important to appreciate that the rate of progression of arthritis can vary significantly between different people. Sometimes, a patient may never require surgery. When the various non-operative measures have failed to control the symptoms of hip arthritis, surgical treatment becomes an option for those patients with significant enough symptoms.

Potential surgical treatments for hip arthritis include:-

• Injection of cortisone/steroid into the hip joint (in theatre under X-ray control)
• Hip arthroscopy (keyhole surgery)
• Hip replacement
• Hip resurfacing
• Custom made hip replacements